Individual provider Active NPI

Stephanie Aileen Ramos, LMFT

  • Marriage & Family Therapist
  • Bothell, WA
National Provider Identifier
1780120345
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61233416 Issued in WA
Practice address
10634 E Riverside Dr Ste 100
Bothell, WA 98011-3751
Phone
(425) 869-2644
Fax
(425) 867-0930
NPI assigned
Jan 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG60960877 WA
Marriage & Family Therapist 106H00000X LF61233416 WA Primary

Addresses

Primary practice location

10634 E Riverside Dr Ste 100
Bothell, WA 98011-3751

Mailing address

8275 166TH Ave NE Ste 200
Redmond, WA 98052-6629
Phone (425) 869-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123003764 WA Practitioner - Marriage and Family Therapist 9830541077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emmaus Counseling Service PSGroup PAC ID 5193726701, 21 clinicians

Practice addresses (Care Compare)

10634 E Riverside Dr
Suite 100
Bothell, WA 98011-3751
Phone 42586926440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MG60960877WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emmaus Counseling Service PS CurrentSince Jan 16, 2024 Accepting new patients

Locations

2122 112th Ave NE
Ste B200
Bellevue, WA 98004

10634 E Riverside Dr
Ste 100
Bothell, WA 98011
Phone 4258692644 ext. 0

8275 166th Ave NE
Ste 200
Redmond, WA 98052
Phone 4258692644 ext. 17

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.stephanieramos@147765.advancedmd-direct.com

Organizations & group practices 1

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": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1780120345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8275 166TH AVE NE STE 200",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526629",
            "telephone_number": "425-869-2644",
            "fax_number": "425-867-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR STE 100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113751",
            "telephone_number": "425-869-2644",
            "fax_number": "425-867-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "STEPHANIE",
        "middle_name": "AILEEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60960877",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61233416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.