Individual provider Active NPI

Nichole A Speaks, LMHCA

  • Counselor
  • Lynnwood, WA
National Provider Identifier
1922526508
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MC61461629 Issued in WA
Practice address
5005 200TH St SW Ste B
Lynnwood, WA 98036-6679
Phone
(425) 772-0707
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counselor 101Y00000X MC61461629 WA Primary

Addresses

Primary practice location

5005 200TH St SW Ste B
Lynnwood, WA 98036-6679

Mailing address

16715 NE Woodinville Duvall Rd
Woodinville, WA 98072-6429
Phone (425) 772-0707

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
MC61461629WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Seed and Bloom Therapy PLLC Mental Health CurrentSince Jul 2, 2023 Accepting new patients
Evergreen Recovery Centers-Lynnwood Detox PastSince Jan 1, 2022 Accepting new patients
Evergreen Recovery Centers-Health Services PastSince Jan 1, 2022 Accepting new patients

Locations

5005 200th St SW
Ste B
Lynnwood, WA 98036
Phone (425) 224-5302

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1922526508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16715 NE WOODINVILLE DUVALL RD",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726429",
            "telephone_number": "425-772-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 200TH ST SW STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366679",
            "telephone_number": "425-772-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAKS",
        "first_name": "NICHOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC61461629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.