Individual provider Active NPI

Joe Bradley Streetman, PHD

  • Mental Health Counselor
  • Richland, WA
National Provider Identifier
1902919384
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00010833 Issued in WA
Practice address
400 Columbia Point Dr Ste 201-B
Richland, WA 99352-4346
Phone
(509) 628-4091
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C2063 OR
Mental Health Counselor 101YM0800X LH00010833 WA Primary

Addresses

Primary practice location

400 Columbia Point Dr Ste 201-B
Richland, WA 99352-4346

Mailing address

400 Columbia Point Dr Ste 201-B
Richland, WA 99352-4346
Phone (509) 628-4091

Other practice location 1

750 George Washington Way
Ste 5
Richland, WA 99352-4247
Phone (509) 628-4091

Other identifiers 1

IdentifierTypeStateIssuer
171037MedicaidOR

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LH00010833WAMDMental Health Counselor
C2063ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Isumataq Corporation Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1902919384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBIA POINT DR STE 201-B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524346",
            "telephone_number": "509-628-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBIA POINT DR STE 201-B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524346",
            "telephone_number": "509-628-4091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 George Washington Way",
            "address_2": "Ste 5",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993524247",
            "country_code": "US",
            "telephone_number": "509-628-4091",
            "fax_number": "509-946-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREETMAN",
        "first_name": "JOE",
        "middle_name": "BRADLEY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2063",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00010833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171037",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.