Blue Harbor Counseling, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LW60398263 Issued in WA

Legal business name

BLUE HARBOR COUNSELING, INC.

Practice address

444 NE Ravenna Blvd Ste 301
Seattle, WA 98115-6467

Phone

(206) 359-0714

NPI assigned

Feb 16, 2015

Last updated

Feb 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Paul TiemeyerNPI 1437342888

Title

President

Phone

(425) 275-2198

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Tiemeyer, MA, LMHC

  • Mental Health Counselor
  • Edmonds, WA
  • NPI 1437342888
  Authorized official Same address or phone

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1053702712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NE RAVENNA BLVD STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 NE RAVENNA BLVD STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156467",
            "telephone_number": "206-359-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HARBOR COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "TIEMEYER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-275-2198"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "LW60398263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.