NPIMap

Organization Active NPI

Rivendell Psychological Services

  • Psychologist
  • Bellingham, WA
National Provider Identifier
1104569623
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
RIVENDELL PSYCHOLOGICAL SERVICES
Practice address
410 W Bakerview Road
Ste 110, Office 148
Bellingham, WA 98226
Phone
(360) 255-8260
Fax
(360) 262-6221
NPI assigned
Apr 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Authorized official

Name
Brian McClincey, MANPI 1275775793
Title
Co-Owner
Phone
(360) 255-8260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

410 W Bakerview Road
Ste 110, Office 148
Bellingham, WA 98226

Mailing address

410 W Bakerview Road
Ste 110, Office 148
Bellingham, WA 98226
Phone (360) 255-8260

National Provider Directory

National Provider Directory

Locations

410 W Bakerview Rd
Ste 110
Bellingham, WA 98226
Phone (360) 255-8260

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1104569623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W BAKERVIEW ROAD",
            "address_2": "STE 110, OFFICE 148",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-255-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W BAKERVIEW ROAD",
            "address_2": "STE 110, OFFICE 148",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-255-8260",
            "fax_number": "360-262-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVENDELL PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "MCCLINCEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "360-255-8260",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.