Individual provider Active NPI

Angela Aphayvanh, MSW, SUDP, LSWAIC

  • Addiction (Substance Use Disorder) Counselor
  • Seattle, WA
National Provider Identifier
1861970832
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP61076749 Issued in WA
Practice address
3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone
(206) 805-8940
NPI assigned
Aug 1, 2018
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP61076749 WA Primary
Social Worker 104100000X SC60708805 WA

Addresses

Primary practice location

3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847

Mailing address

3639 MLK Jr Way S
Seattle, WA 98144-6847
Phone (206) 695-7600

Other identifiers 1

IdentifierTypeStateIssuer
2111734MedicaidWA

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
CP61076749WAMDAddiction (Substance Use Disorder) Counselor
SC60708805WAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1861970832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MLK JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-695-7600",
            "fax_number": "206-695-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 MARTIN LUTHER KING JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-805-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APHAYVANH",
        "first_name": "ANGELA",
        "credential": "MSW, SUDP, LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61076749",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SC60708805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2111734",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.