Individual provider Active NPI

Juneaux Sebastian Wilde, M.ED., LMHC, LPC

  • Mental Health Counselor
  • Port Townsend, WA
National Provider Identifier
1861007916
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
61320033 Issued in WA
Practice address
282084 US Highway 101
Port Townsend, WA 98368-9331
Phone
(360) 320-6683
NPI assigned
Sep 14, 2020
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 61320033 WA Primary
Mental Health Counselor 101YM0800X 7756 ID

Addresses

Primary practice location

282084 US Highway 101
Port Townsend, WA 98368-9331

Mailing address

1791 E Avenida de Las Flores
Thousand Oaks, CA 91362-1522
Phone (360) 320-6683

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
Master of Education

State licenses

LicenseStateTypeSpecialty
7756IDMDMental Health Counselor
61320033WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1861007916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 E AVENIDA DE LAS FLORES",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913621522",
            "telephone_number": "360-320-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282084 US HIGHWAY 101",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983689331",
            "telephone_number": "360-320-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "JUNEAUX",
        "middle_name": "SEBASTIAN",
        "credential": "M.ED., LMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2020-09-14",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61320033",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "7756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.