NPIMap

Organization Active NPI

Center for Child and Family Therapy PC Inc

  • Marriage & Family Therapist
  • Bremerton, WA
National Provider Identifier
1013060870
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF00001897 Issued in WA
Legal business name
CENTER FOR CHILD AND FAMILY THERAPY PC INC
Practice address
7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242
Phone
(360) 698-9258
Fax
(360) 698-9296
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David B Walker, MA LMFT
Title
Owner
Phone
(360) 698-9258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X LH00006918 WA
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X LW00005617 WA
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X LF00001897 WA Primary

Addresses

Primary practice location

7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242

Mailing address

7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242
Phone (360) 698-9258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090701000529 WA Part B Supplier - Clinic/Group Practice 5193760056 Receives reassigned benefits from 2 practitioners
Practice locations: Bremerton, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1013060870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 OLD MILITARY RD NE STE 103",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113242",
            "telephone_number": "360-698-9258",
            "fax_number": "360-698-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 OLD MILITARY RD NE STE 103",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113242",
            "telephone_number": "360-698-9258",
            "fax_number": "360-698-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CHILD AND FAMILY THERAPY PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-698-9258",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006918",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005617",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF00001897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.