Individual provider Active NPI

Carlee Ann Myer, CAAR

  • Peer Specialist
  • Centralia, WA
National Provider Identifier
1154035855
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CG61509360 Issued in WA
Practice address
3510 Steelhammer Dr
Centralia, WA 98531-4551
Phone
(360) 623-8020
Fax
(360) 237-5675
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CG61509360 WA Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

3510 Steelhammer Dr
Centralia, WA 98531-4551

Mailing address

2428 W Reynolds Ave
Centralia, WA 98531-4554
Phone (360) 330-9044

Other practice location 1

10015 Lakewood Dr SW
Lakewood, WA 98499-3838
Phone (855) 223-7123

Other names 1

  • Carlee Churchel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CG61509360WAMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Evaluation and Treatment Center PastSince Dec 17, 2023 Accepting new patients
Cascade Community Healthcare PastSince Dec 17, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1154035855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 W REYNOLDS AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314554",
            "telephone_number": "360-330-9044",
            "fax_number": "360-237-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020",
            "fax_number": "360-237-5675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10015 Lakewood Dr SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984993838",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYER",
        "first_name": "CARLEE",
        "middle_name": "ANN",
        "credential": "CAAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61509360",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLEE",
            "last_name": "CHURCHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centralia, WA

Sources for this page

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