Olympia Psychotherapy Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

34139400 Issued in WA

Legal business name

OLYMPIA PSYCHOTHERAPY INC

Practice address

1408 State Ave NE Ste 110
Olympia, WA 98506-4481

Phone

(360) 352-3034

Fax

(360) 352-3035

NPI assigned

Jul 15, 2013

Last updated

Jul 15, 2013By 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

Jennifer Goodwin, MA LMHC CDPNPI 1396793725

Title

President/Program Director

Phone

(360) 352-3034

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.

• Jennifer L Goodwin, MA, LMHC, CDP

  • Mental Health Counselor
  • Olympia, WA
  • NPI 1396793725
  NPD (past) Authorized official

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1104267558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 STATE AVE NE STE 110",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064481",
            "telephone_number": "360-352-3034",
            "fax_number": "360-352-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 STATE AVE NE STE 110",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064481",
            "telephone_number": "360-352-3034",
            "fax_number": "360-352-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA PSYCHOTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "360-352-3034",
        "authorized_official_credential": "MA LMHC CDP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "34139400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olympia Orthopaedic Associates, PLLC
• Olympia Orthopaedic Associates, PLLC
• Olympia Orthopaedic Associates, PLLC
• Olympia Pain Institute, PLLC
• Olympia Pediatrics, PLLC
• Olympia Radiologists, P.S.
• Olympia Respiratory Services, LLC
• Olympia Respiratory Services, LLC (AdaptHealth)
• Olympia School District
• Olympia Senior Care, LLC (Senior Helpers)

• Community/Behavioral Health Agency in Olympia, WA
• Providers in Olympia, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.