Sheila Nicole Mansurov, MA, LMHC, SOTP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60184919 Issued in WA

Practice address

11415 NE 128TH St Ste 100
Kirkland, WA 98034-6314

Phone

(425) 298-6223

NPI assigned

Nov 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• A New Beginning Counseling Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkland, WA
  • NPI 1437547007
  NPD (past) Authorized official
• Hallie Condit, Licsw

  • Clinical Social Worker
  • Kirkland, WA
  • NPI 1407803786
  NPD (past)

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1962655050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 NE 128TH ST STE 100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-298-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11415 NE 128TH ST STE 100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346314",
            "telephone_number": "425-298-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSUROV",
        "first_name": "SHEILA",
        "middle_name": "NICOLE",
        "credential": "MA, LMHC, SOTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "FC 60206027",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60184919",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039799",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Manke
• Jessica Mannard
• Fredrik Mansfield, MSW, MDIV
• Theron Angus Manson I, DDS
• Iqra Mansoor
• Manual Therapy International P.S., P.L.L.C.
• Judi Lee Mar-Burbidge, PHARMD, FASCP
• Douglas H Mar, OD
• Kaysee Mar, LMHCA
• Lyle Ardon Marcus-Love, D.C.

• Mental Health Counselor in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.