Lara Amalia Collis, M.A.

Primary specialty

CounselorTaxonomy code 101Y00000X

License

RC00053143 Issued in WA

Practice address

3712 S Ferdinand St
Seattle, WA 98118-1736

Phone

(206) 723-2825

Fax

(206) 282-3640

NPI assigned

Jan 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Greatland Mental Health LLCGroup PAC ID 4385794437, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Greatland Mental Health, LLC

  • Psychiatry Physician
  • Anchorage, AK
  • NPI 1477743532
  Medicare reassignment Care Compare group NPD
• Cowlitz

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1114259553
  NPD (past)
• United Indians of All Tribes Foundation

  • Case Management Agency
  • Seattle, WA
  • NPI 1972795581
  NPD (past)

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1194055400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W. GOVERNMENT WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98199",
            "telephone_number": "206-723-2825",
            "fax_number": "206-282-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 S FERDINAND ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181736",
            "telephone_number": "206-723-2825",
            "fax_number": "206-282-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIS",
        "first_name": "LARA",
        "middle_name": "AMALIA",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00053143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Collins, P.T.
• Tracy L Collins, PHD PSYCHOLOGIST
• Trisha Collins, PHARMD
• William Kenneth Collins
• Alexandra C Collis, MD
• Carolina Marie Collison, MSN, NP
• Charles Frederick Collison
• Eric A Collisson, MD
• James Connelley Collyer, M.D.
• Victor A. Collymore, M.D.

• Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.