Individual provider Active NPI

Justice R Stegall

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1932983004
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61565106 Issued in WA
Practice address
100 N Howard St
Spokane, WA 99201-0508
Phone
(478) 538-6873
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X GA
Mental Health Counselor 101YM0800X MC61565106 WA Primary

Addresses

Primary practice location

100 N Howard St
Spokane, WA 99201-0508

Mailing address

100 N Howard St Ste W
Spokane, WA 99201-0508

Other practice location 1

940 sr 96
warner robins, GA 31088-7515
Phone (478) 538-6873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260603000412 WA Practitioner - Mental Health Counselor 6901377746 Reassigns benefits to 2 organizations
I20260605001306 GA Practitioner - Mental Health Counselor 6901377746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7877 Willow Chase Blvd
Houston, TX 77070-5934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC61565106WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Flint Behavioral Healthcare PastSince May 21, 2023 Accepting new patients

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1932983004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "478-538-6873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 sr 96",
            "address_purpose": "LOCATION",
            "city": "warner robins",
            "state": "GA",
            "postal_code": "310887515",
            "country_code": "US",
            "telephone_number": "478-538-6873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEGALL",
        "first_name": "JUSTICE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-07-12",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61565106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.