Active NPI
Xavier Blue
- Addiction (Substance Use Disorder) Counselor
- Shelton, WA
National Provider Identifier
1770047680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 3737 N Shelton Springs Rd
Shelton, WA 98584-9105 - Phone
- (678) 814-7371
- NPI assigned
- Jan 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | WA | Primary |
Addresses
Primary practice location
3737 N Shelton Springs Rd
Shelton, WA 98584-9105
Mailing address
4211 Quail Dr SE
Lacey, WA 98503-5504
Phone (678) 814-7371
Other practice location 1
6005 Tyee Dr SW
Tumwater, WA 98512-7356
Phone (678) 814-7371
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1770047680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 QUAIL DR SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035504",
"telephone_number": "678-814-7371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 N SHELTON SPRINGS RD",
"city": "SHELTON",
"state": "WA",
"postal_code": "985849105",
"telephone_number": "678-814-7371"
}
],
"practiceLocations": [
{
"address_1": "6005 Tyee Dr SW",
"address_purpose": "LOCATION",
"city": "Tumwater",
"state": "WA",
"postal_code": "985127356",
"country_code": "US",
"telephone_number": "678-814-7371",
"fax_number": "360-586-9728",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLUE",
"first_name": "XAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-24",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.