Individual provider Active NPI

Rayme Mkwananzi

  • Mental Health Counselor
  • Longview, WA
National Provider Identifier
1992174510
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
720 14TH Avenue
Longview, WA 98632
Phone
(360) 423-0203
Fax
(360) 577-0269
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X WA Primary

Addresses

Primary practice location

720 14TH Avenue
Longview, WA 98632

Mailing address

921 14TH Avenue
Longview, WA 98632
Phone (360) 423-0203

Other practice location 1

15609 SE Mill Plain Blvd
Vancouver, WA 98684-8952
Phone (360) 433-9664

Other practice location 2

13505 NE 10th Ave
Vancouver, WA 98685-2711
Phone (360) 433-9664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Refresh Therapy, Inc CurrentSince Feb 1, 2025 Accepting new patients
Refresh Therapy, Inc Mental Health Past Accepting new patients

Locations

15609 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 215-3242

13505 NE 10th Ave
Vancouver, WA 98685
Phone (360) 433-9664

15609 SE Mill Plain Blvd
Ste 200
Vancouver, WA 98684

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1992174510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15609 SE Mill Plain Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986848952",
            "country_code": "US",
            "telephone_number": "360-433-9664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13505 NE 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986852711",
            "country_code": "US",
            "telephone_number": "360-433-9664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MKWANANZI",
        "first_name": "RAYME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.