Individual provider Active NPI

Stephanie Jordan Mrakovich, LMHCA

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1881180610
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60792355 Issued in WA
Practice address
3417 Evanston Ave N Ste 309
Seattle, WA 98103-8967
Phone
(346) 298-1093
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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 MC60792355 WA Primary

Addresses

Primary practice location

3417 Evanston Ave N Ste 309
Seattle, WA 98103-8967

Mailing address

2484 Dexter Ave N Apt 2
Seattle, WA 98109-2245
Phone (630) 981-7456

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
MC60792355WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1881180610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 DEXTER AVE N APT 2",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092245",
            "telephone_number": "630-981-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 309",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038967",
            "telephone_number": "346-298-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAKOVICH",
        "first_name": "STEPHANIE",
        "middle_name": "JORDAN",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60792355",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 5, 2018; 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.