Kizziea Terry Stubblefield, AAC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG61444852 Issued in WA

Practice address

5001 112TH St E
Tacoma, WA 98446-5307

Phone

(253) 531-2103

NPI assigned

Jul 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Prosperity Counseling & Treatment SVCS

  dba Prosperity Wellness Center

  • Substance Abuse Rehabilitation Facility
  • Tacoma, WA
  • NPI 1972634939
  NPD
• Prosperity Counseling & Treatment Services Inc.

  dba Prosperity Wellness Center

  • Community/Behavioral Health Agency
  • Tacoma, WA
  • NPI 1750821781
  NPD (past)

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1710723606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 PACIFIC AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984445126",
            "telephone_number": "253-531-2103",
            "fax_number": "253-536-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 112TH ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984465307",
            "telephone_number": "253-531-2103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12201 Pacific Ave S",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984445126",
            "country_code": "US",
            "telephone_number": "253-531-2103",
            "fax_number": "253-536-6637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBBLEFIELD",
        "first_name": "KIZZIEA",
        "middle_name": "TERRY",
        "credential": "AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61444852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Michelle Stuart, MOT OTR/L C/NDT IMHE
• Paula L Stuart, M.D.
• Ralph V Stuart, RPH
• Robert E. Stuart, M.D.
• Eileen Kathryn Stubblefield, L.M.H.C.
• Linda Natalia Stuckert
• Maria Stukenborg, MS, RDN
• Bethany Stull, LMP
• Peter Stull, MD
• Veronica Stull, LPN

• Peer Specialist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.