NPIMap

Organization Active NPI

Squaxin Island Tribe

Doing business as Mental Health Skillbuilders

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelton, WA
National Provider Identifier
1023226685
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
600371470 Issued in WA
Legal business name
SQUAXIN ISLAND TRIBE
Doing business as
Mental Health Skillbuilders
Practice address
90 SE Klah Che Min Drive
Shelton, WA 98584
Phone
(360) 427-9006
Fax
(360) 427-1951
NPI assigned
May 18, 2007
Last updated
Jul 25, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SQUAXIN ISLAND TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Authorized official

Name
Edward J Fox, PHD
Title
HHS Director
Phone
(360) 427-9006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 600371470 WA Primary

Addresses

Primary practice location

90 SE Klah Che Min Drive
Shelton, WA 98584

Mailing address

90 SE Klah Che Min Drive
Shelton, WA 98584
Phone (360) 427-9006

Other identifiers 1

IdentifierTypeStateIssuer
1980994MedicaidWA

Other names 1

  • Mental Health Skillbuilders Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Squaxin Island Tribe11 organizations share this tax ID, including this one
Part of
Squaxin Island Tribe

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1023226685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 SE KLAH CHE MIN DRIVE",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "98584",
            "telephone_number": "360-427-9006",
            "fax_number": "360-427-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SE KLAH CHE MIN DRIVE",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "98584",
            "telephone_number": "360-427-9006",
            "fax_number": "360-427-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUAXIN ISLAND TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SQUAXIN ISLAND TRIBE",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "HHS DIRECTOR",
        "authorized_official_telephone_number": "360-427-9006",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WA",
            "license": "600371470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980994",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Health Skillbuilders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.