Individual provider Active NPI

Susanna Jorgenson

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1831703495
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61205262 Issued in WA
Practice address
522 W Riverside Ave Ste N
Spokane, WA 99201-0580
Phone
(253) 549-3861
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X MC61205262 WA Primary

Addresses

Primary practice location

522 W Riverside Ave Ste N
Spokane, WA 99201-0580

Mailing address

522 W Riverside Ave Ste N
Spokane, WA 99201-0580
Phone (253) 549-3861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251118000707 WA Practitioner - Mental Health Counselor 0547751588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

201 W N River Dr
Suite 301
Spokane, WA 99201-2262
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC61205262WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Nov 4, 2025 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

201 W North River Dr
Ste 301
Spokane, WA 99201
Phone (509) 496-0724

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1831703495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE N",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "253-549-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE N",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "253-549-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "SUSANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2022-07-13",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61205262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.