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ANNE THERESA BORNHOLDT
NPI 1669114237
Counselor - Mental Health in Sequim, WA

Active since April 12, 2022Opted out of Medicare · through May 1, 2027
302 SECOR RD, SEQUIM, WA 98382(360) 774-6904 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Anne Theresa Bornholdt NPPES

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

ANNE THERESA BORNHOLDT (NPI 1669114237) is an individual mental health provider in Sequim, Washington, licensed in Washington (MC61236741) and active in the NPI registry since April 2022. She has opted out of Medicare through May 1, 2027.

NPPES Registry Identity

NPI1669114237
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameANNE THERESA BORNHOLDT
Location Address302 SECOR RDSequim, WA 98382-9720
Mailing Address302 Secor RdSequim, WA 98382-9720 · (360) 774-6904
Phone(360) 774-6904
Sole ProprietorYes
Enumeration DateApril 12, 2022
NPPES CertifiedApril 12, 2022
✔ NPI 1669114237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · MC61236741
302 SECOR RD, Sequim, WA 98382
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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

ⓘ

Opted out of Medicare

Anne Theresa Bornholdt 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 May 1, 2025 through May 1, 2027.

Opt-Out Effective DateMay 1, 2025
Opt-Out In Effect ThroughMay 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Anne Bornholdt's NPI number?

The NPI number for Anne Bornholdt is 1669114237. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Anne Bornholdt located?

Anne Bornholdt practices at 302 Secor Rd, Sequim, WA 98382. The listed phone number is (360) 774-6904.

What is Anne Bornholdt's specialty?

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

Is Anne Bornholdt enrolled in Medicare?

No. Anne Bornholdt has opted out of Medicare through May 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Anne Bornholdt accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Anne Bornholdt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anne Bornholdt was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.