Cassie Ann Icenogle, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6326 Martin Way E Ste 200
Lacey, WA 98516-5570

Phone

(360) 506-4886

Fax

(360) 878-8536

NPI assigned

Jul 25, 2018

Last updated

Sep 8, 2021By the provider in NPPES

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wright Mind Family PsychiatryGroup PAC ID 8426403445, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cicenogle195128@ghc.direct-ci.net

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

• Wright Mind Family Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Olympia, WA
  • NPI 1679292775
  Medicare reassignment Care Compare group NPD
• Krave Lyfe Mental Health Counseling

  • Mental Health Counselor
  • Lacey, WA
  • NPI 1467074609
  NPD Authorized official

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1891272506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5153",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985095153",
            "telephone_number": "360-506-4886",
            "fax_number": "360-878-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 MARTIN WAY E STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165570",
            "telephone_number": "360-506-4886",
            "fax_number": "360-878-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICENOGLE",
        "first_name": "CASSIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01",
            "identifier": "DEVDREELOO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01",
            "identifier": "DEVDREWLOO",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.krave-lyfe.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6326 Martin Way E Ste 200",
            "city": "Lacey",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985165570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amer Hussaini
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• Idalis Inc
• Kristina Lorraine Ikerd, LMP
• Illuminaura Emdr & Psychotherapy, PLLC
• Indian Health Service
• Ellen Ingram, BCBA

• Mental Health Counselor in Lacey, WA
• Providers in Lacey, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.