Active NPI
Mark Anthony Goebel
- Addiction (Substance Use Disorder) Counselor
- Olympia, WA
National Provider Identifier
1770084832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO60752047
- Practice address
- 508 5TH Avenue SE
Olympia, WA 98501 - Phone
- (360) 754-2324
- NPI assigned
- Feb 23, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | WA | ||
| Mental Health Counselor | 101YM0800X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60752047 | WA | Primary |
Addresses
Primary practice location
508 5TH Avenue SE
Olympia, WA 98501
Mailing address
508 5TH Avenue SE
Olympia, WA 98501
Phone (360) 754-2324
Other practice location 1
508 5th Avenue SE
Olympia, WA 98501
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
| License | State | Type | Specialty |
|---|---|---|---|
| CO60752047 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1770084832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 5TH AVENUE SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98501",
"telephone_number": "360-754-2324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 5TH AVENUE SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98501",
"telephone_number": "360-754-2324"
}
],
"practiceLocations": [
{
"address_1": "508 5th Avenue SE",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "98501",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOEBEL",
"first_name": "MARK",
"middle_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-23",
"last_updated": "2022-08-08",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60752047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
- GN Hearing Care Corp (Beltone Electronics)
- Juanita Michelle Gober, MIDWIFE, CPM, LM
- Kathy A Goble, M.D.
- God-S-Land
- Patricia Anne Godleman, LMHP
- Goerig and Behnen, DDS., P.S. (Northwest Endodontic Specialists)
- Albert Charles Goerig, BS,DDS,MS
- David Charles Goerig, DDS
- Silva Goetz, LMHC
- Brittany Goff, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.