Individual provider Active NPI

Susan Michele Myers, RRT, LMFT, CDPT

  • Marriage & Family Therapist
  • Ferndale, WA
National Provider Identifier
1801077409
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60640207 Issued in WA
Practice address
2076 Main St Unit 4
Ferndale, WA 98248-9468
Phone
(360) 334-7370
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60563710 WA
Critical Care Registered Respiratory Therapist 2279C0205X LR60329133 WA
Marriage & Family Therapist 106H00000X LF60640207 WA Primary

Addresses

Primary practice location

2076 Main St Unit 4
Ferndale, WA 98248-9468

Mailing address

PO Box 445
Ferndale, WA 98248-0445

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
I20250106003710 WA Practitioner - Marriage and Family Therapist 0345778270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO60563710WAMDAddiction (Substance Use Disorder) Counselor
LF60640207WAMDMarriage & Family Therapist
LR60329133WAMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Harbor Therapy Group Marriage & Family Therapist CurrentSince Apr 1, 2018 Accepting new patients

Locations

2076 Main St
Unit 4
Ferndale, WA 98248
Phone (360) 334-7370

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": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1801077409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982480445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 MAIN ST UNIT 4",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982489468",
            "telephone_number": "360-334-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SUSAN",
        "middle_name": "MICHELE",
        "credential": "RRT, LMFT, CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60563710",
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "WA",
            "license": "LR60329133",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60640207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, WA

Sources for this page

Verify at the official NPI Registry.