NPIMap

Organization Active NPI

Sound Family Center, LLC

Doing business as Kaeli A. Clark

  • Addiction (Substance Use Disorder) Counselor
  • Woodinville, WA
National Provider Identifier
1811304025
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
60295090 Issued in WA
Legal business name
SOUND FAMILY CENTER, LLC
Doing business as
Kaeli A. Clark
Practice address
17924 140TH Ave NE
Ste#230
Woodinville, WA 98072-4315
Phone
(206) 419-9168
Fax
(206) 555-5555
NPI assigned
Jul 21, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Kaeli A Clark, CDPNPI 1427397124
Title
Owner
Phone
(206) 419-9168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 60295090 WA Primary

Addresses

Primary practice location

17924 140TH Ave NE
Ste#230
Woodinville, WA 98072-4315

Mailing address

17924 140TH Ave NE
Ste #230
Woodinville, WA 98072
UM
Phone (206) 419-9168

Other names 1

  • Kaeli A. Clark Doing business as

National Provider Directory

National Provider Directory

Locations

17924 140th Ave NE
Ste 230
Woodinville, WA 98072
Phone (206) 419-9168

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1811304025",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "17924 140TH AVE NE",
            "address_2": "STE #230",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "206-419-9168",
            "fax_number": "206-555-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17924 140TH AVE NE",
            "address_2": "STE#230",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980724315",
            "telephone_number": "206-419-9168",
            "fax_number": "206-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND FAMILY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAELI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-419-9168",
        "authorized_official_credential": "CDP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "60295090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaeli A. Clark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.