Individual provider Active NPI

Katrina Estrada, BHCM

  • Mental Health Counselor
  • Lacey, WA
National Provider Identifier
1760070296
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG61134905 Issued in WA
Practice address
612 Woodland Square Loop SE Ste 401
Lacey, WA 98503-1070
Phone
(360) 763-5828
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CG61134905 WA
Mental Health Counselor 101YM0800X CG61134905 WA Primary

Addresses

Primary practice location

612 Woodland Square Loop SE Ste 401
Lacey, WA 98503-1070

Mailing address

1600 S Lane St
Seattle, WA 98144-2810
Phone (206) 282-2371

Other practice location 1

1600 S Lane St
Seattle, WA 98144-2810
Phone (206) 282-2371

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
CG61134905WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Health and Recovery Services CurrentSince Jun 18, 2023 Accepting new patients
Thurston Mason Behavioral Health Organization PastSince Jun 18, 2023 Accepting new patients

Locations

612 Woodland Square Loop SE
Ste 401
Olympia, WA 98503
Phone (360) 763-5796

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1760070296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S LANE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442810",
            "telephone_number": "206-282-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 WOODLAND SQUARE LOOP SE STE 401",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031070",
            "telephone_number": "360-763-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Lane St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442810",
            "country_code": "US",
            "telephone_number": "206-282-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "KATRINA",
        "credential": "BHCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61134905",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61134905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.