Individual provider Active NPI

Conne Fritzi Guerrero

  • Counselor
  • Moses Lake, WA
National Provider Identifier
1780179283
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
840 E Plum St
Moses Lake, WA 98837-1874
Phone
(509) 765-9239
Fax
(509) 765-4124
NPI assigned
Jun 27, 2018
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

840 E Plum St
Moses Lake, WA 98837-1874

Mailing address

840 E Plum St
Moses Lake, WA 98837-1874
Phone (509) 765-9239

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
I20240709002702 WA Practitioner - Mental Health Counselor 4981149408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grant County Health District CurrentSince May 12, 2024 Accepting new patients
County of Grant CurrentSince May 12, 2024 Accepting new patients
Cityview Past Accepting new patients

Locations

840 E Plum St
Moses Lake, WA 98837
Phone (509) 764-6325

Organizations & group practices 3

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1780179283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E PLUM ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371874",
            "telephone_number": "509-765-9239",
            "fax_number": "509-765-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E PLUM ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371874",
            "telephone_number": "509-765-9239",
            "fax_number": "509-765-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "CONNE",
        "middle_name": "FRITZI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.