Roger Robert Baerwolf

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60684326 Issued in WA

Practice address

1300 114TH Ave SE Ste 104
Bellevue, WA 98004-6928

Phone

(425) 616-3800

Fax

(425) 217-0162

NPI assigned

Jun 4, 2017

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Northshore Youth and Family Services

  • Community/Behavioral Health Agency
  • Bothell, WA
  • NPI 1952609133
  NPD (past)

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

{
    "created_epoch": "1496534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1841728870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980720343",
            "telephone_number": "425-877-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 114TH AVE SE STE 104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046928",
            "telephone_number": "425-616-3800",
            "fax_number": "425-217-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAERWOLF",
        "first_name": "ROGER",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-04",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60684326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Bae, PT
• Vivienne Bae, LMHC
• Yi K. Bae
• Emily Barbara Baer
• Martina F. Baer, LMP
• Amy J Bagatto, MD
• Alimohammad Bagha
• Kulminder Bahi, DMD
• Aimee Leanna Bahr
• Jessica Hui Bai, DMD

• Mental Health Counselor in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.