VANESSA G DZIVAKWE PHD
NPI 1013340793
Psychologist in Seattle, WA

Active since August 16, 2013Opted out of Medicare · through Jan 1, 2027
509 OLIVE WAY STE 204, SEATTLE, WA 98101(206) 329-5255(206) 726-1878 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jun 13, 2017 and 3 more (6 updates tracked since 2016).

About Vanessa G Dzivakwe Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VANESSA G DZIVAKWE PHD (NPI 1013340793) is an individual psychologist in Seattle, Washington, licensed in Washington (PY 60666097) and active in the NPI registry since August 2013. She has opted out of Medicare through January 1, 2027 and remains eligible to order and refer and maintains a secondary practice location in Seattle.

NPPES Registry Identity

NPI1013340793
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameVANESSA G DZIVAKWECredential: PHD
Location Address509 OLIVE WAY STE 204Seattle, WA 98101-1726
Mailing Address509 Olive Way Ste 204Seattle, WA 98101-1726 · (206) 329-5255 · Fax (206) 726-1878
Fax(206) 726-1878
Sole ProprietorNo
Enumeration DateAugust 16, 2013
Last NPPES UpdateJuly 21, 20226 updates tracked since enumeration
NPI 1013340793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WA · PY 60666097
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

509 OLIVE WAY STE 204, Seattle, WA 98101

Secondary Practice Location 1

Location 1818 12th AveSeattle, WA 98122-4410 · Phone (206) 329-5255 ext. 302 · Fax (206) 726-1878

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Vanessa G Dzivakwe Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2017 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2017
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Psychologist (Rehabilitation)
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Community/Behavioral Health
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Psychologist (Clinical)
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Nurse Practitioner (Psychiatric/Mental Health)
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Psychologist
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Psychologist
509 OLIVE WAY STE 204
SEATTLE, WA 98101
Community/Behavioral Health
509 OLIVE WAY STE 204
SEATTLE, WA 98101

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013340793, enumerated as an "individual" on August 16, 2013.

The provider is located at 509 OLIVE WAY STE 204 SEATTLE, WA 98101 and the phone number is (206) 329-5255.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: PacificSource Health Plans. Please consult your insurance carrier or call the provider to verify.