Individual provider Active NPI

Cheryl De Roca, M.A., M.S.

  • Mental Health Counselor
  • Mill Creek, WA
National Provider Identifier
1720640592
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61276727 Issued in WA
Practice address
16300 Mill Creek Blvd Ste 208a
Mill Creek, WA 98012-1737
Phone
(425) 224-5233
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X LH61276727 WA Primary

Addresses

Primary practice location

16300 Mill Creek Blvd Ste 208a
Mill Creek, WA 98012-1737

Mailing address

16300 Mill Creek Blvd Ste 208a
Mill Creek, WA 98012-1737
Phone (425) 224-5233

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 Science

State licenses

LicenseStateTypeSpecialty
LH61276727WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1720640592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 MILL CREEK BLVD STE 208A",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121737",
            "telephone_number": "425-224-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 MILL CREEK BLVD STE 208A",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121737",
            "telephone_number": "425-224-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROCA",
        "first_name": "CHERYL",
        "credential": "M.A., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61276727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.