SUSANNAH SONG MISIASZEK (LMHC, SUDP) – Mental Health Counselor, NPI 1063702678

SUSANNAH SONG MISIASZEK (LMHC, SUDP) is a healthcare provider. based in Tacoma, Washington. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LMHC, SUDP. The NPI Number for SUSANNAH SONG MISIASZEK (LMHC, SUDP) is 1063702678

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
SUSANNAH SONG MISIASZEK (LMHC, SUDP)
NPI
1063702678
Phone
(253) 238-7260
Address
12201 PACIFIC AVE S
Enumeration Date
15 April 2011
Last Update Date
29 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3605753314
Graduation Year
2010 (16 years ago)
PAC ID
6204275522
Group Practice PAC ID
8820030133
Professional Enrollment ID
I20250804001318
Address ID
WA983278781DU1000XPLXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:15State licenses:0Digital endpointsOther names

1,452 MENTAL HEALTH COUNSELOR in WA

Provider Addresses for SUSANNAH SONG MISIASZEK (LMHC, SUDP)

  • 12201 PACIFIC AVE S

    TACOMA, WA 984445126

    Phone: (253) 238-7260

    Type: Mailing

  • 4300 SW 13TH ST

    GAINESVILLE, FL 326084006

    Phone: (352) 374-5600

    Fax: (352) 374-5608

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240419001471IMental Health CounselorWATBD
I20250804001318IMental Health CounselorTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98444)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820030133View full group profile
NameSpecialtyState
-WA
Mental Health CounselorWA
Nurse PractitionerID
Nurse PractitionerWA
-WA
Clinical Social WorkerWA
Mental Health CounselorWA
-WA
Nurse PractitionerWA
Mental Health CounselorWA

Reviews

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Frequently asked questions

What is the registry number for SUSANNAH SONG MISIASZEK (LMHC, SUDP)?
The registry entry for SUSANNAH SONG MISIASZEK (LMHC, SUDP) shows NPI 1063702678.
Does the public listing show SUSANNAH SONG MISIASZEK (LMHC, SUDP) as active?
SUSANNAH SONG MISIASZEK (LMHC, SUDP)'s NPI record reflects an active status in NPPES.
What services align with SUSANNAH SONG MISIASZEK (LMHC, SUDP)'s listing?
SUSANNAH SONG MISIASZEK (LMHC, SUDP)'s public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What city is tied to SUSANNAH SONG MISIASZEK (LMHC, SUDP)?
The directory associates SUSANNAH SONG MISIASZEK (LMHC, SUDP) with Tacoma, Washington. Check all listed addresses for suites or satellite offices.
Why is information missing for SUSANNAH SONG MISIASZEK (LMHC, SUDP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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