Lake Aspen Integrative Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LAKE ASPEN INTEGRATIVE SERVICES

Practice address

1460 N 16TH Ave Ste G
Yakima, WA 98902-7102

Phone

(509) 594-1867

Fax

(509) 575-7796

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Melissa Simmons, LICSWNPI 1891292348

Title

Owner

Phone

(509) 594-1867

Specialties & licenses 4

Addresses

Other names 1

• Lake Aspen Integrative Services Former legal business name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 2

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

• Elisabeth Ann Dunbar, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Toppenish, WA
  • NPI 1396031266
  Medicare reassignment NPD
• Melissa Simmons, LICSW

  • Clinical Social Worker
  • Yakima, WA
  • NPI 1891292348
  NPD Authorized official

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1033926282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE STE G",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-594-1867",
            "fax_number": "509-575-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE STE G",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-594-1867",
            "fax_number": "509-575-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ASPEN INTEGRATIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-594-1867",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Aspen Integrative Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Laura L Lafevers
• Penelope Lafond
• Brenda A Lago, LMP
• Jennifer Ann Lago, LMP
• Joseph Young Lai
• Lake Aspen Professional Group PS
• Yvonne Christine Lakey
• Lally Chiropractic Clinic PS
• Scott A. Lally, D.C.
• Thomas P Lally, DC

• Psychiatry Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.