Active NPI
Cansas Eleanor Wilson, LF 61245115
- Mental Health Counselor
- Buckley, WA
National Provider Identifier
1891344255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFTA.MG.61001288
- Practice address
- 227 S Cedar St # 1861
Buckley, WA 98321-2803 - Phone
- (253) 651-1361
- NPI assigned
- Sep 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFTA.MG.61001288 | WA | Primary |
Addresses
Primary practice location
227 S Cedar St # 1861
Buckley, WA 98321-2803
Mailing address
PO Box 1861
Buckley, WA 98321-1861
Phone (253) 651-1361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFTA.MG.61001288 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1891344255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1861",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983211861",
"telephone_number": "253-651-1361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 S CEDAR ST # 1861",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983212803",
"telephone_number": "253-651-1361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CANSAS",
"middle_name": "ELEANOR",
"credential": "LF 61245115",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MFTA.MG.61001288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.