Jeanne Heather Wicomb, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF00001898 Issued in WA

Practice address

1601 114TH Ave SE
Suite 180
Bellevue, WA 98004-6950

Phone

(425) 451-1134

Fax

(425) 451-8501

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Integrated Wisdom Therapy, PLLC

  • Professional Counselor
  • Renton, WA
  • NPI 1538784376
  NPD Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881716595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE",
            "address_2": "THE MOORE CENTER, SUITE 180",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046950",
            "telephone_number": "425-451-1134",
            "fax_number": "425-451-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE",
            "address_2": "SUITE 180",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046950",
            "telephone_number": "425-451-1134",
            "fax_number": "425-451-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICOMB",
        "first_name": "JEANNE",
        "middle_name": "HEATHER",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF00001898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "W904633",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caresse Wicheta, RN
• Jenelle Christine Wicker, LMP
• Connie Anderson Wickland
• Nichole C Wicklein
• Arika Raaya Wickramasinha
• Sierra Widmer-Rodriguez, PA-C
• Kay Wieben
• Priscilla P Wig, DMD
• Elizabeth Wignall, MS, LGC
• Ann Hutchison Wilbour, R.PH.

• Marriage & Family Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Marriage & Family Therapist in Washington

• 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.