Ethan Jon Blackstone , MFTA
Counselor • Bellevue, WA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Ethan Blackstone has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Ethan Blackstone, MFTA was a registered Counselor practicing in Bellevue, WA. Throughout an active medical career spanning 2 years, Ethan Blackstone provided care at the practice location at 14216 NE 21ST ST until profile deactivation on 2020-09-30.
Practice Location & Contact Primary Location
14216 Ne 21st St
Bellevue, WA 980073720
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor in Bellevue, WA
Practicing in Bellevue, WA (11556 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2020-10-13NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
NUCC Taxonomy Code: 390200000X
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Student in an Organized Health Care Education/Training Program
Counselor - Professional
Student in an Organized Health Care Education/Training Program
Counselor
Student in an Organized Health Care Education/Training Program
Counselor - Mental Health
Bachelor of Arts, AAC
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Recorded as ETHAN BLACKSTONE, MFTA
Counselor
Record officially reactivated for active practice on October 09, 2020
Record deactivated on September 30, 2020
NPI status registered as active in NPPES database
Registered at 14216 NE 21ST ST, BELLEVUE, WA 980073720 (Tel: 4256535000)
Registered at 6400 SOUTHCENTER BLVD, TUKWILA, WA 981882547
Recorded as ETHAN BLACKSTONE
Student in an Organized Health Care Education/Training Program
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
6400 Southcenter Blvd
Tukwila, WA 981882547
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