Individual provider Active NPI

Andrew R Visser, MA

  • Mental Health Counselor
  • Silverdale, WA
National Provider Identifier
1750442778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00010412 Issued in WA
Practice address
9201 Silverdale Way NW
Silverdale, WA 98383
Phone
(360) 698-4860
Fax
(360) 698-3849
NPI assigned
Dec 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LH00010412 WA Primary

Addresses

Primary practice location

9201 Silverdale Way NW
Silverdale, WA 98383

Mailing address

PO Box 3428
Silverdale, WA 98383
Phone (360) 698-4860

Other names 1

  • Andy Visser Other name

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
LH00010412WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nilsson Audiology & Hearing Aid Clinic LLC PastSince Jan 1, 2012 Accepting new patients
Peninsula Psychological Center, Inc., P.S. PastSince Sep 18, 2013 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750442778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-4860",
            "fax_number": "360-698-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 SILVERDALE WAY NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-4860",
            "fax_number": "360-698-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSER",
        "first_name": "ANDREW",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00010412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "VISSER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.