Individual provider Active NPI

Janet Moczulewski, LMFT

  • Marriage & Family Therapist
  • Issaquah, WA
National Provider Identifier
1982086997
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60883473 Issued in WA
Practice address
640 NW Gilman Blvd # 101
Issaquah, WA 98027-2476
Phone
(206) 817-5616
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF60883473 WA Primary

Addresses

Primary practice location

640 NW Gilman Blvd # 101
Issaquah, WA 98027-2476

Mailing address

640 NW Gilman Blvd # 101
Issaquah, WA 98027-2476
Phone (206) 817-5616

Other identifiers 1

IdentifierTypeStateIssuer
831934939OtherIRS

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
LF60883473WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Connections, PLLC Marriage & Family Therapist CurrentSince Nov 9, 2021 Accepting new patients

Locations

1495 NW Gilman Blvd
Ste 11
Issaquah, WA 98027
Phone (425) 217-2525

640 NW Gilman Blvd
Ste 101
Issaquah, WA 98027
Phone (206) 817-5616

Organizations & group practices 1

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1982086997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NW GILMAN BLVD # 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272476",
            "telephone_number": "206-817-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NW GILMAN BLVD # 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272476",
            "telephone_number": "206-817-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCZULEWSKI",
        "first_name": "JANET",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60883473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "831934939",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.