Active NPI
Patricia A Fawver, PHD
- Mental Health Counselor
- Tacoma, WA
National Provider Identifier
1831633684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CL 60173225
- Practice address
- 2009 70TH Ave W
Tacoma, WA 98466-5540 - Phone
- (253) 564-8408
- NPI assigned
- Dec 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CL 60173225 | WA | Primary |
| Specialist | 174400000X |
Addresses
Primary practice location
2009 70TH Ave W
Tacoma, WA 98466-5540
Mailing address
2009 70TH Ave W
Tacoma, WA 98466-5540
Phone (253) 564-8408
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL 60173225 | Other | WA | COUNSELOR CERTIFIED CERTIFICATION |
| 601369893 | Other | WA | UBI |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CL 60173225 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481587200000",
"number": "1831633684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2009 70TH AVE W",
"city": "TACOMA",
"state": "WA",
"postal_code": "984665540",
"telephone_number": "253-564-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2009 70TH AVE W",
"city": "TACOMA",
"state": "WA",
"postal_code": "984665540",
"telephone_number": "253-564-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWVER",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-13",
"last_updated": "2016-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CL 60173225",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNSELOR CERTIFIED CERTIFICATION",
"identifier": "CL 60173225",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBI",
"identifier": "601369893",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.