Individual provider Active NPI

Persephone Ann Brooks

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1821394552
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG60308556 Issued in WA
Practice address
122 16TH Ave E
Sound Mental Health
Seattle, WA 98112-5212
Phone
(206) 302-2200
Fax
(206) 302-2710
NPI assigned
Jan 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CG60308556 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

122 16TH Ave E
Sound Mental Health
Seattle, WA 98112-5212

Mailing address

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

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

State licenses

LicenseStateTypeSpecialty
CG60308556WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1821394552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 16TH AVE E",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125212",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "PERSEPHONE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60308556",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.