NPIMap

Organization Active NPI

Eastside Play Therapy

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1922587328
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60579749 Issued in WA
Legal business name
EASTSIDE PLAY THERAPY
Practice address
13401 Bel-Red Road NE Ste B-12
Bellevue, WA 98005-2945
Phone
(206) 350-7506
Fax
(206) 582-7030
NPI assigned
Aug 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Kristina Perry, MED, LMHC, RPT-SNPI 1275826638
Title
Counselor
Phone
(405) 919-5089

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LH60579749 WA Primary

Addresses

Primary practice location

13401 Bel-Red Road NE Ste B-12
Bellevue, WA 98005-2945

Mailing address

13401 Bel-Red Road NE Ste B-12
Bellevue, WA 98005
Phone (206) 350-7506

Other practice location 1

12900 NE 180th St Ste 160
Bothell, WA 98011-5778
Phone (206) 350-7506

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1922587328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13401 BEL-RED ROAD NE STE B-12",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "206-350-7506",
            "fax_number": "206-582-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13401 BEL-RED ROAD NE STE B-12",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052945",
            "telephone_number": "206-350-7506",
            "fax_number": "206-582-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12900 NE 180th St Ste 160",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980115778",
            "country_code": "US",
            "telephone_number": "206-350-7506",
            "fax_number": "206-582-7030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTSIDE PLAY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "405-919-5089",
        "authorized_official_credential": "MED, LMHC, RPT-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60579749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.