NPIMap

Organization Active NPI

Magnolia Behavioral and Holistic Health

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1164186730
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MAGNOLIA BEHAVIORAL AND HOLISTIC HEALTH
Practice address
2512 E Evergreen Blvd # 1188
Vancouver, WA 98661-4323
Phone
(360) 773-8964
NPI assigned
Oct 28, 2021
Last updated
Jun 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Authorized official

Name
Tinamarie Fish, LMHC, MHP, CCTPNPI 1598007148
Title
Owner
Phone
(360) 773-8964

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: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

2512 E Evergreen Blvd # 1188
Vancouver, WA 98661-4323

Mailing address

PO Box 826
Ridgefield, WA 98642-0826
Phone (360) 773-8964

Other names 1

  • Tinamarie Fish LMHC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1164186730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 826",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986420826",
            "telephone_number": "360-773-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 E EVERGREEN BLVD # 1188",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614323",
            "telephone_number": "360-773-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIORAL AND HOLISTIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "TINAMARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-773-8964",
        "authorized_official_credential": "LMHC, MHP, CCTP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tinamarie Fish LMHC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tinamarie Fish LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.