Marvin Malalad Acosta, AAC
Individual provider Active NPI Mental Health Counselor · Redmond, WA
NPI 1831530690 · NPPES record last updated Jul 15, 2013
Key facts
- NPI
- 1831530690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CG60391927 (WA)
- Practice address
- 11629 Avondale Rd NE
Avondale
Redmond, WA 98052-2201 - Phone
- (425) 653-5070
- Fax
- (425) 653-5071
- NPI assigned
- Jul 9, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60391927 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60391927 | WA | |
| Mental Health Counselor | 101YM0800X | CG60391927 | WA | Yes |
Addresses
Primary practice location
11629 Avondale Rd NE
Avondale
Redmond, WA 98052-2201
Mailing address
1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200
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All providers in Redmond, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.