Individual provider Active NPI

Jennifer Sue Wareham, LMFT

  • Marriage & Family Therapist
  • Eastsound, WA
National Provider Identifier
1962593293
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
60642442 Issued in WA
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

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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
770COMDAddiction (Substance Use Disorder) Counselor
51363653902UTMDMarriage & Family Therapist
60642442WAMDMarriage & Family Therapist
6229IDMDPhysical 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.

Verify at the official NPI Registry.