NPIMap

Organization Active NPI

Neurofeedback and Counseling PLLC

  • Clinical Social Worker
  • Bothell, WA
National Provider Identifier
1740500438
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3955-P Issued in OK
Legal business name
NEUROFEEDBACK AND COUNSELING PLLC
Practice address
17921 Bothell Everett Hwy Ste 101
Bothell, WA 98012-0013
Phone
(524) 610-9241
Fax
(425) 806-4600
NPI assigned
Jun 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Authorized official

Name
Beatriz Roskopf, LICSW
Title
Owner
Phone
(425) 610-9241

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 3955-P OK Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

17921 Bothell Everett Hwy Ste 101
Bothell, WA 98012-0013

Mailing address

17921 Bothell Everett Hwy Ste 101
Bothell, WA 98012-0013
Phone (524) 620-9241

National Provider Directory

National Provider Directory

Locations

17921 Bothell Everett Hwy
Ste 101
Bothell, WA 98012
Phone (425) 806-4600

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1740500438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17921 BOTHELL EVERETT HWY STE 101",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980120013",
            "telephone_number": "524-620-9241",
            "fax_number": "258-064-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17921 BOTHELL EVERETT HWY STE 101",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980120013",
            "telephone_number": "524-610-9241",
            "fax_number": "425-806-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROFEEDBACK AND COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "ROSKOPF",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-610-9241",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3955-P",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 23, 2019; 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.