Individual provider Active NPI

Signal Diymoke Mitchell

  • Counselor
  • Seattle, WA
National Provider Identifier
1962825489
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1700 Airport Way S
Seattle, WA 98134-1618
Phone
(206) 223-3644
Fax
(206) 223-1482
NPI assigned
Feb 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1700 Airport Way S
Seattle, WA 98134-1618

Mailing address

10828 Gravelly Lake Dr SW Ste 106
Lakewood, WA 98499-1300
Phone (253) 651-1841

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

Practice roles

OrganizationSpecialtyStatusNew patients
Motivational Residential Care Residential Treatment Facility, Intellectual and/Or Developmental Disabilities Current Accepting new patients
Universal Alternatives, LLC. Current Accepting new patients

Locations

10828 Gravelly Lake Dr SW
Ste 106
Lakewood, WA 98499
Phone (253) 300-0537

Organizations & group practices 2

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": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1962825489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 GRAVELLY LAKE DR SW STE 106",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991300",
            "telephone_number": "253-651-1841",
            "fax_number": "253-267-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 AIRPORT WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341618",
            "telephone_number": "206-223-3644",
            "fax_number": "206-223-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SIGNAL",
        "middle_name": "DIYMOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.