Healthcare Provider Details

I. General information

NPI: 1083942155
Provider Name (Legal Business Name): JODI APONTE CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3624 COLBY AVE
EVERETT WA
98201
US

IV. Provider business mailing address

PO BOX 12598
EVERETT WA
98206-2598
US

V. Phone/Fax

Practice location:
  • Phone: 425-366-8517
  • Fax: 844-247-8630
Mailing address:
  • Phone: 425-258-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP60163373
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSC60480365
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number078797-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: