Cheryl D'Ettorre

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY60841321 Issued in WA

Practice address

2830 228TH Ave SE
Sammamish, WA 98075-9300

Phone

(425) 614-5649

NPI assigned

Mar 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Avanti

  • Mental Health Counselor
  • Sammamish, WA
  • NPI 1932618014
  NPD (past) Authorized official

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1942768759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 228TH AVE SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759300",
            "telephone_number": "425-614-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 228TH AVE SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759300",
            "telephone_number": "425-614-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ETTORRE",
        "first_name": "CHERYL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY60841321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "PY60841321",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nyeri A Crater, CB
• Jenean Rene Creason, BCBA, LBA, MIT
• Lisa Kristine Criswell, PSY.D.
• Sharon Crook, ARNP
• Evan R Culbert, DPT
• Joyce E Dahners
• Rebecca Dallain, LMT
• Alaia Pauline Wesli Davies
• Christina Davis
• Rachel Davis, LMHC

• Counseling Psychologist in Sammamish, WA
• Providers in Sammamish, WA by specialty
• Counseling Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.