NPIMap

Individual provider Active NPI

Sharon Kay Stultz, MA, MED, LMHCA, EDSP

  • Mental Health Counselor
  • Bothell, WA
National Provider Identifier
1710609102
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
61477333 Issued in WA
Practice address
22722 29TH Dr SE Ste 153
Bothell, WA 98021-4401
Phone
(425) 215-9382
NPI assigned
Sep 13, 2022
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X 61477333 WA Primary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 522320A WA

Addresses

Primary practice location

22722 29TH Dr SE Ste 153
Bothell, WA 98021-4401

Mailing address

22722 29TH Dr SE
Bothell, WA 98021-4401
Phone (425) 215-9382

Other practice location 1

414 Front St N
Issaquah, WA 98027-2914
Phone (425) 392-6367 ext. 252

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clientservices@friendsofyouth.org Direct Friends of Youth

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Master of Education

State licenses

LicenseStateTypeSpecialty
61477333WAMDMental Health Counselor
522320AWAMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways of Learning CurrentSince Nov 3, 2024 Accepting new patients
Friends of Youth Mental Health Past Accepting new patients
Friends of Youth Past Accepting new patients

Locations

22722 29th Dr SE
Ste 153
Bothell, WA 98021
Phone (425) 215-9382

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1710609102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22722 29TH DR SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214401",
            "telephone_number": "425-215-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22722 29TH DR SE STE 153",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214401",
            "telephone_number": "425-215-9382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Front St N",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980272914",
            "country_code": "US",
            "telephone_number": "425-392-6367 x252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "SHARON",
        "middle_name": "KAY",
        "credential": "MA, MED, LMHCA, EDSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61477333",
            "primary": true
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "WA",
            "license": "522320A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clientservices@friendsofyouth.org",
            "affiliation": "Y",
            "endpointDescription": "client services email",
            "affiliationName": "Friends of Youth",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "414 Front St N",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980272914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.