Individual provider Active NPI

Sandra Ann Harris, LMHC

  • Mental Health Counselor
  • Issaquah, WA
National Provider Identifier
1851478366
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00003770 Issued in WA
Practice address
545 Rainier Blvd N
Ste # 4
Issaquah, WA 98027-2806
Phone
(425) 392-3364
Fax
(425) 392-5587
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00003770 WA Primary

Addresses

Primary practice location

545 Rainier Blvd N
Ste # 4
Issaquah, WA 98027-2806

Mailing address

545 Rainier Blvd N
Ste # 4
Issaquah, WA 98027-2806
Phone (425) 392-3364

Other names 1

  • Mrs. Sandra Ann Klettke-Harris Other name

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

State licenses

LicenseStateTypeSpecialty
LH00003770WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851478366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 RAINIER BLVD N",
            "address_2": "STE # 4",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272806",
            "telephone_number": "425-392-3364",
            "fax_number": "425-392-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 RAINIER BLVD N",
            "address_2": "STE # 4",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272806",
            "telephone_number": "425-392-3364",
            "fax_number": "425-392-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00003770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "KLETTKE-HARRIS",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.