Lucelly M. Medeiros Rivera

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CG61139749 Issued in WA

Practice address

3808 S Angeline St, Seattle, Wa 98118
Seattle, WA 98118

Phone

(206) 461-4880

NPI assigned

Oct 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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.

• Consejo Counseling and Referral Service - Lake City

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1073090858
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1962977447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 NE 125TH ST STE 145",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254357",
            "telephone_number": "206-437-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 S ANGELINE ST, SEATTLE, WA 98118",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98118",
            "telephone_number": "206-461-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13940 NE 166th St",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980729085",
            "country_code": "US",
            "telephone_number": "787-464-5529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDEIROS RIVERA",
        "first_name": "LUCELLY",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "RBT-15-09036",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61139749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Elaine Mecum, L.M.P
• Brendan Rayvonne Medbury
• Danielle Medbury, CO61179392
• Stephanie Anne Medearis, LPN
• Mededge Systems
• Carina Terese Medeiros, EAMP
• Patrick A Medeiros, CDP
• Medex NW
• Jillian Medford
• Medica Helath LLC

• Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.