MRS. SANTI WIBAWANTINI MA, LMFT
NPI 1295079390
Marriage & Family Therapist in Everett, WA

Q: What is Santi Wibawantini's NPI number?

The NPI number for Santi Wibawantini is 1295079390. It was assigned to this individual provider in the NPPES registry on November 15, 2012.

Q: What is Santi Wibawantini's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Santi Wibawantini was last updated on September 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2012PECOS Enrolled

2930 MAPLE ST, EVERETT, WA 98201(888) 287-2680 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 28, 2022, Jan 23, 2019, Aug 27, 2018 (3 updates tracked since 2018).

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About Mrs. Santi Wibawantini Ma, Lmft NPPES

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

MRS. SANTI WIBAWANTINI MA, LMFT (NPI 1295079390) is an individual marriage & family therapist in Everett, Washington, licensed in Washington (LF60637556) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mountlake Terrace.

NPPES Registry Identity

NPI1295079390

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMRS. SANTI WIBAWANTINICredential: MA, LMFT

Location Address2930 MAPLE STEverett, WA 98201-3832

Mailing Address5508 234th St SwMountlake Terrace, WA 98043-4746 · (425) 448-8094

Phone(888) 287-2680

Sole ProprietorYes

Enumeration DateNovember 15, 2012

Last NPPES UpdateSeptember 28, 20223 updates tracked since enumeration

NPPES CertifiedSeptember 28, 2022

✔ NPI 1295079390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in WA · LF60637556

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2930 MAPLE ST, Everett, WA 98201

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Secondary Practice Location 1

Location 15508 234th St SWMountlake Terrace, WA 98043-4746 · Phone (425) 245-3772

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Santi Wibawantini Ma, Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

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