Individual provider Active NPI

Nadezhda Kosanovskaya, LMFT, CDPT, CMHS

  • Marriage & Family Therapist
  • Tukwila, WA
National Provider Identifier
1871035675
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60849905 Issued in WA
Practice address
15455 65TH Ave S
Tukwila, WA 98188-2534
Phone
(206) 721-5170
Fax
(206) 721-6288
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60733863 WA
Marriage & Family Therapist 106H00000X LF60849905 WA Primary

Addresses

Primary practice location

15455 65TH Ave S
Tukwila, WA 98188-2534

Mailing address

PO Box 2429
Longview, WA 98632-8486
Phone (360) 353-9494

Other practice location 1

1600 148th Ave SE Ste A
Bellevue, WA 98007-6852
Phone (253) 948-2312

Other practice location 2

10512 NE 68th St Ste 202
Kirkland, WA 98033-7063
Phone (253) 948-2312

Other practice location 3

610 E 57th St
Tacoma, WA 98404-1924
Phone (253) 948-2312

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
CO60733863WAMDAddiction (Substance Use Disorder) Counselor
LF60849905WAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1871035675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9494",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 65TH AVE S",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882534",
            "telephone_number": "206-721-5170",
            "fax_number": "206-721-6288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 148th Ave SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980076852",
            "country_code": "US",
            "telephone_number": "253-948-2312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10512 NE 68th St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980337063",
            "country_code": "US",
            "telephone_number": "253-948-2312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 E 57th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984041924",
            "country_code": "US",
            "telephone_number": "253-948-2312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSANOVSKAYA",
        "first_name": "NADEZHDA",
        "credential": "LMFT, CDPT, CMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60733863",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60849905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.