Diverse Behavioral Health Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVERSE BEHAVIORAL HEALTH CLINIC LLC

Practice address

3516 7TH Ave SW Ste a
Olympia, WA 98502-5011

Phone

(360) 533-3216

NPI assigned

Sep 20, 2023

Last updated

Sep 20, 2023By 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

Dara Bernal

Title

Owner

Phone

(360) 533-3216

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1073391041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5482",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985095482",
            "telephone_number": "360-533-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 7TH AVE SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025011",
            "telephone_number": "360-533-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE BEHAVIORAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "BERNAL",
        "authorized_official_first_name": "DARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-533-3216"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Discovery Therapy Services NW
• Hannah Leigh Diseth
• Carrie Distefano, IBCLC
• Daniel Ditlow, CPC
• Jessica M Divens, LMT
• William Dix, PHARM.D
• Ashley S.R. Dixon, LMP
• Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC
• Kevin A DO, DPT
• Chantal E Dobbins

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.