Active NPI
Jennifer Sue Wareham, LMFT
- Marriage & Family Therapist
- Eastsound, WA
National Provider Identifier
1962593293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 60642442
- Practice address
- 550 Deer Harbor Rd
Eastsound, WA 98245-9201 - Phone
- (720) 626-7293
- Fax
- (360) 850-2037
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 770 | CO | |
| Marriage & Family Therapist | 106H00000X | 51363653902 | UT | |
| Marriage & Family Therapist | 106H00000X | 6229 | ID | |
| Marriage & Family Therapist | 106H00000X | 60642442 | WA | Primary |
Addresses
Primary practice location
550 Deer Harbor Rd
Eastsound, WA 98245-9201
Mailing address
550 Deer Harbor Rd
Eastsound, WA 98245-9201
Phone (720) 626-7293
Other names 1
- Jennifer Sue Taylor
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
| License | State | Type | Specialty |
|---|---|---|---|
| 770 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| 51363653902 | UT | MD | Marriage & Family Therapist |
| 60642442 | WA | MD | Marriage & Family Therapist |
| 6229 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756339200000",
"number": "1962593293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 DEER HARBOR RD",
"city": "EASTSOUND",
"state": "WA",
"postal_code": "982459201",
"telephone_number": "720-626-7293",
"fax_number": "360-850-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 DEER HARBOR RD",
"city": "EASTSOUND",
"state": "WA",
"postal_code": "982459201",
"telephone_number": "720-626-7293",
"fax_number": "360-850-2037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAREHAM",
"first_name": "JENNIFER",
"middle_name": "SUE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2025-08-28",
"certification_date": "2025-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "770",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "51363653902",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "ID",
"license": "6229",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "60642442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "TAYLOR",
"middle_name": "SUE",
"credential": "LMFT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Eastsound, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.