John Lawrence Churchward Sr., CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60437986

Practice address

3629 S D St
Tacoma, WA 98418-6813

Phone

(253) 798-3545

NPI assigned

Dec 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Freedom Recovery Center LLC

  • Addiction (Substance Use Disorder) Counselor
  • Bonney Lake, WA
  • NPI 1487884441
  NPD (past)
• New Freedom Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bonney Lake, WA
  • NPI 1215352018
  NPD (past)

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1174095020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 S D ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984186813",
            "telephone_number": "253-798-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3629 S D ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984186813",
            "telephone_number": "253-798-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHWARD",
        "first_name": "JOHN",
        "middle_name": "LAWRENCE",
        "name_suffix": "Sr.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "CP60437986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Chung, MA SUDPT
• Timothy Chung, MD
• Youn Kyu Chung, EAMP
• Josiah Chupik
• Haley Church, MA
• Roul Wolfgang Chwalek, R.PH.
• William Thomas Chythlook, M.D.
• Kelsey Marie Cibicki, DNP
• Martin V Cieri, MD
• Sharon Ann Cinnamon, OTA

• Addiction (Substance Use Disorder) Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.