Individual provider Active NPI

Paulette Ellen De Coriolis, MA, LMHCA

  • Mental Health Counselor
  • Redmond, WA
National Provider Identifier
1730587635
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60620693 Issued in WA
Practice address
15600 Redmond Way Ste 201
Redmond, WA 98052-3862
Phone
(425) 417-3525
Fax
(425) 881-8481
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60620693 WA Primary

Addresses

Primary practice location

15600 Redmond Way Ste 201
Redmond, WA 98052-3862

Mailing address

15600 Redmond Way Ste 201
Redmond, WA 98052-3862
Phone (425) 417-3525

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

State licenses

LicenseStateTypeSpecialty
MC60620693WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1730587635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 REDMOND WAY STE 201",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523862",
            "telephone_number": "425-417-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 REDMOND WAY STE 201",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523862",
            "telephone_number": "425-417-3525",
            "fax_number": "425-881-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CORIOLIS",
        "first_name": "PAULETTE",
        "middle_name": "ELLEN",
        "credential": "MA, LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60620693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.