Individual provider Active NPI

Michelle Marie Mann, ED.D

  • Counselor
  • Seattle, WA
National Provider Identifier
1720239387
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
RC00046851 Issued in WA
Practice address
2200 Rainier Ave S Ste 201
Seattle, WA 98144-4642
Phone
(206) 417-9904
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC00046851 WA Primary

Addresses

Primary practice location

2200 Rainier Ave S Ste 201
Seattle, WA 98144-4642

Mailing address

21428 95TH PL W
Edmonds, WA 98020-3318
Phone (206) 235-3167

Other practice location 1

21428 95th Pl W
Edmonds, WA 98020-3318
Phone (206) 235-3167

Other identifiers 1

IdentifierTypeStateIssuer
2167721MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
RC00046851WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
You Grow Girl CurrentSince Apr 11, 2021 Accepting new patients

Locations

2200 Rainier Ave S
#201
Seattle, WA 98144
Phone (206) 417-9904

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1720239387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21428 95TH PL W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203318",
            "telephone_number": "206-235-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RAINIER AVE S STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444642",
            "telephone_number": "206-417-9904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21428 95th Pl W",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980203318",
            "country_code": "US",
            "telephone_number": "206-235-3167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ED.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00046851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167721",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.