Restart Life, PLLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

RESTART LIFE, PLLC

Practice address

26509 NE Virginia St
Duvall, WA 98019-6210

Phone

(800) 682-6934

Fax

(888) 788-3419

NPI assigned

Jan 4, 2012

Organization subpart

No

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

Authorized official

Name

Cosette Dawna Rae, MSWNPI 1609939891

Title

Ceo

Phone

(800) 682-6934

Specialties & licenses 9

Addresses

Other names 1

• Restart Internet Addiction Recovery Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cosette Dawna Rae, LSWAIC, NCTMB, LMP,

  • Clinical Social Worker
  • Fall City, WA
  • NPI 1609939891
  NPD Authorized official
• Vickie Jo, MA, LMHCA

  • Mental Health Counselor
  • Bellevue, WA
  • NPI 1619536117
  NPD (past)
• Johnny S Tock, MS, LMHC

  • Professional Counselor
  • Bellevue, WA
  • NPI 1861002925
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1801166103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 290TH AVE SE",
            "city": "FALL CITY",
            "state": "WA",
            "postal_code": "980247403",
            "telephone_number": "800-682-6934",
            "fax_number": "888-788-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26509 NE VIRGINIA ST",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980196210",
            "telephone_number": "800-682-6934",
            "fax_number": "888-788-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 156th Ave NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073827",
            "country_code": "US",
            "telephone_number": "800-682-6934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTART LIFE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "COSETTE",
        "authorized_official_middle_name": "DAWNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-682-6934",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60152285",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restart Internet Addiction Recovery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Restart Internet Addiction Recovery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychiatric Residential Treatment Facility in Duvall, WA
• Providers in Duvall, WA by specialty
• Psychiatric Residential Treatment Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.