BLACK SPACE LLC
NPI 1427860022
Counselor - Mental Health in Bothell, WA
About Black Space Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLACK SPACE LLC (NPI 1427860022) is a healthcare organization registered as a mental health in Bothell, Washington and active in the NPI registry since January 2025. The organization lists Tamera Gittens, Lmhc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Black Space Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Black Space LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Black Space LLC's NPI number?
The NPI number for Black Space LLC is 1427860022. It was assigned to this organization in the NPPES registry on January 22, 2025.
Where is Black Space LLC located?
Black Space LLC is located at 22722 29th Drive Southeast Suite 100, Bothell, WA 98021. The listed phone number is (929) 445-7277.
What is Black Space LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Black Space LLC enrolled in Medicare?
Yes. Black Space LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Black Space LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Black Space LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Black Space LLC was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Black Space Llc · NPI 1427860022
Mental Health organization in Bothell, Washington. Organization record, active in the CMS NPPES registry since January 22, 2025.
## Identity
- **NPI:** 1427860022 (Entity type: Organization)
- **Enumerated:** January 22, 2025
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Tamera Gittens, LMHC
## Practice location
- **Address:** 22722 29TH DRIVE SOUTHEAST SUITE 100, Bothell, WA 98021
- **Phone:** (929) 445-7277
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 22, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1427860022) · Data from the CMS NPPES public registry.