Active NPI
Michael Vernon Blankinship, B.A., A.A.C
- Mental Health Counselor
- Chehalis, WA
National Provider Identifier
1790217628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CG 60505175
- Practice address
- 28 SW Chehalis Ave
Chehalis, WA 98532-1933 - Phone
- (360) 736-2619
- Fax
- (360) 740-2770
- NPI assigned
- Mar 30, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CG 60505175 | WA | Primary |
Addresses
Primary practice location
28 SW Chehalis Ave
Chehalis, WA 98532-1933
Mailing address
2428 W Reynolds Ave
Centralia, WA 98531-4554
Phone (360) 330-9044
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG 60505175 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1790217628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2428 W REYNOLDS AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314554",
"telephone_number": "360-330-9044",
"fax_number": "360-736-3139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 SW CHEHALIS AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985321933",
"telephone_number": "360-736-2619",
"fax_number": "360-740-2770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANKINSHIP",
"first_name": "MICHAEL",
"middle_name": "VERNON",
"name_prefix": "Mr.",
"credential": "B.A., A.A.C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-30",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG 60505175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.