Roger Edwin Iino, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00006127 Issued in WA

Practice address

5801 23Rd Dr W Ste 104
Everett, WA 98203-1587

Phone

(425) 513-8213

Fax

(425) 513-0534

NPI assigned

Aug 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1801442926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14704 27TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557415",
            "telephone_number": "206-351-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 23RD DR W STE 104",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031587",
            "telephone_number": "425-513-8213",
            "fax_number": "425-513-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IINO",
        "first_name": "ROGER",
        "middle_name": "EDWIN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Everett, WA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.