Active NPI
Marisol A Hanley, PHD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1972574671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY2922
- Practice address
- 3417 Evanston Ave N Ste 204
Seattle, WA 98103-8644 - Phone
- (206) 854-4269
- Fax
- (800) 991-2996
- NPI assigned
- Jan 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PY2922 | WA | |
| Clinical Psychologist | 103TC0700X | PY2922 | WA | Primary |
Addresses
Primary practice location
3417 Evanston Ave N Ste 204
Seattle, WA 98103-8644
Mailing address
1307N 45TH St 200
Seattle, WA 98103-6741
Phone (206) 854-4269
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041110001042 | WA | Practitioner - Clinical Psychologist | 4486617396 | Practice locations: Seattle, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3417 Evanston Ave N
Suite 206
Seattle, WA 98103-8644
Phone (206) 854-4269
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY2922 | WA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1972574671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307N 45TH ST 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036741",
"telephone_number": "206-854-4269",
"fax_number": "206-420-4841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3417 EVANSTON AVE N STE 204",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981038644",
"telephone_number": "206-854-4269",
"fax_number": "800-991-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANLEY",
"first_name": "MARISOL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "WA",
"license": "PY2922",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY2922",
"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 Apr 5, 2023; 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.