Individual provider Active NPI

Daesoleil Peterson Henry

  • Marriage & Family Therapist
  • Snoqualmie, WA
National Provider Identifier
1841828456
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
8226 Bracken PL SE Ste 200
Snoqualmie, WA 98065-2935
Phone
(425) 842-3910
NPI assigned
Mar 30, 2020
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

8226 Bracken PL SE Ste 200
Snoqualmie, WA 98065-2935

Mailing address

37509 SE Fury St
Snoqualmie, WA 98065-9593
Phone (661) 714-3606

Other practice location 1

1500 E Hamilton Ave Ste 105
Campbell, CA 95008-0834
Phone (408) 772-3775

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced ABA Inc CurrentSince Dec 15, 2024 Accepting new patients
Courtney Bell, PLLC CurrentSince Oct 22, 2023 Accepting new patients

Locations

1500 E Hamilton Ave
Ste 105
Campbell, CA 95008
Phone (408) 412-2427

8226 Bracken Pl SE
Ste 200
Snoqualmie, WA 98065
Phone (425) 380-5576

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1841828456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37509 SE FURY ST",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659593",
            "telephone_number": "661-714-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8226 BRACKEN PL SE STE 200",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980652935",
            "telephone_number": "425-842-3910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Hamilton Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "950080834",
            "country_code": "US",
            "telephone_number": "408-772-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON HENRY",
        "first_name": "DAESOLEIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.