Individual provider Active NPI

Enjouli Cammie Steward, CG 60832872

  • Addiction (Substance Use Disorder) Counselor
  • Fife, WA
National Provider Identifier
1891279949
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60893863 Issued in WA
Practice address
5005 Pacific Hwy E Ste 20
Fife, WA 98424-2647
Phone
(253) 922-6522
Fax
(253) 922-6955
NPI assigned
Sep 24, 2018
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional 405300000X 60832872 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60893863 WA Primary

Addresses

Primary practice location

5005 Pacific Hwy E Ste 20
Fife, WA 98424-2647

Mailing address

13014 97TH Ave E
Puyallup, WA 98373-9145
Phone (253) 283-8866

Other practice location 1

17002 Pacific Ave S
Spanaway, WA 98387-8253
Phone (253) 583-2323

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
CP60893863WAMDAddiction (Substance Use Disorder) Counselor
60832872WAMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Atlas Counseling LLC Addiction (Substance Use Disorder) CurrentSince Feb 18, 2024 Accepting new patients
Kassuhn Inc Dba Alternative Counseling Past Accepting new patients
Kassuhn Inc Past Accepting new patients

Locations

5005 Pacific Hwy E
Ste 20
Fife, WA 98424
Phone (253) 922-6522

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1891279949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13014 97TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983739145",
            "telephone_number": "253-283-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 PACIFIC HWY E STE 20",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242647",
            "telephone_number": "253-922-6522",
            "fax_number": "253-922-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17002 Pacific Ave S",
            "address_purpose": "LOCATION",
            "city": "Spanaway",
            "state": "WA",
            "postal_code": "983878253",
            "country_code": "US",
            "telephone_number": "253-583-2323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWARD",
        "first_name": "ENJOULI",
        "middle_name": "CAMMIE",
        "name_prefix": "Ms.",
        "credential": "CG 60832872",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "WA",
            "license": "60832872",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60893863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fife, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.