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JC EPHRAIM JR. CCC, SUDP, MHP, CAAL
NPI 1497028823
Counselor - Mental Health in Renton, WA

Active since February 15, 2012PECOS Enrolled
15 S GRADY WAY STE 310, RENTON, WA 98057(206) 726-0430 Get Directions Write a Review

NPPES record last updated: July 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 12, 2025, May 7, 2024 (2 updates tracked since 2024).

About Jc Ephraim Jr. Ccc, Sudp, Mhp, Caal NPPES

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

JC EPHRAIM JR. CCC, SUDP, MHP, CAAL (NPI 1497028823) is an individual mental health provider in Renton, Washington, licensed in Washington (CU61584983) and active in the NPI registry since February 2012. He is enrolled in Medicare PECOS and maintains a secondary practice location in Renton.

NPPES Registry Identity

NPI1497028823
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJC EPHRAIM JR.Credential: CCC, SUDP, MHP, CAAL
Location Address15 S GRADY WAY STE 310Renton, WA 98057-3215
Mailing AddressPo Box 6385Kent, WA 98064-6385 · (206) 650-4024
Phone(206) 726-0430
Sole ProprietorNo
Enumeration DateFebruary 15, 2012
Last NPPES UpdateJuly 12, 20252 updates tracked since enumeration
NPPES CertifiedJuly 12, 2025
✔ NPI 1497028823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in WA · CU61584983✔ Licensed in WA · CL60461451
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CP00001663 (WA)
15 S GRADY WAY STE 310, Renton, WA 98057
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Secondary Practice Location 1

Location 115 S Grady Way Ste 241Renton, WA 98057-3209 · Phone (206) 650-4024

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jc Ephraim Jr. Ccc, Sudp, Mhp, Caal 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 4

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

JERRY EUGENE GREEN M.A.
Counselor (Professional)
15 S GRADY WAY STE 310
RENTON, WA 98057
King County (425) 652-1886
GAYLE ROBINSON RN
Registered Nurse
15 S GRADY WAY STE 310
RENTON, WA 98057
King County (206) 726-0430
MICHELL ALLERT
Counselor (Mental Health)
15 S GRADY WAY STE 310
RENTON, WA 98057
King County (206) 726-0430
SISTERS IN COMMON
Community/Behavioral Health
15 S GRADY WAY STE 310
RENTON, WA 98057
King County (206) 726-0430

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 Jc Ephraim's NPI number?

The NPI number for Jc Ephraim is 1497028823. It was assigned to this individual provider in the NPPES registry on February 15, 2012.

Where is Jc Ephraim located?

Jc Ephraim practices at 15 S Grady Way Ste 310, Renton, WA 98057. The listed phone number is (206) 726-0430.

What is Jc Ephraim's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jc Ephraim enrolled in Medicare?

Yes. Jc Ephraim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jc Ephraim was last updated on July 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.