Organization Active NPI

Ultimate Professional Mental Health Services Corp

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1154061513
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ULTIMATE PROFESSIONAL MENTAL HEALTH SERVICES CORP
Practice address
748 Market St # 135
Tacoma, WA 98402-3737
Phone
(832) 819-4378
Fax
(253) 954-3116
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Annabel Owusu, NURSE PRACTITIONER
Title
Pmhnp
Phone
(614) 804-0866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

748 Market St # 135
Tacoma, WA 98402-3737

Mailing address

748 Market St # 135
Tacoma, WA 98402-3737
Phone (832) 819-4378

National Provider Directory

National Provider Directory

Locations

748 Market St
#135
Tacoma, WA 98402
Phone (832) 819-4378

Practitioners & affiliated clinicians

Practitioners 1

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": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1154061513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 MARKET ST # 135",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023737",
            "telephone_number": "832-819-4378",
            "fax_number": "253-954-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 MARKET ST # 135",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023737",
            "telephone_number": "832-819-4378",
            "fax_number": "253-954-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE PROFESSIONAL MENTAL HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "OWUSU",
        "authorized_official_first_name": "ANNABEL",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "614-804-0866",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

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