NPIMap

Organization Active NPI

Catholic Community Services of Western Washington

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Burlington, WA
National Provider Identifier
1225449929
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
29164800 Issued in WA
Legal business name
CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Practice address
614 Peterson Rd
Burlington, WA 98233-2606
Phone
(360) 757-0131
Fax
(360) 757-0136
NPI assigned
May 15, 2014
Last updated
Oct 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
Stephanie M. Thelen
Title
Compliance & Policy Analyst
Phone
(253) 761-3898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 29164800 WA Primary

Addresses

Primary practice location

614 Peterson Rd
Burlington, WA 98233-2606

Mailing address

515 Lakeway Dr
Bellingham, WA 98225-5233
Phone (360) 676-2187

Other names 1

  • Burlington Recovery Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Catholic Community Services WW34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

515 Lakeway Dr
Bellingham, WA 98225
Phone (360) 676-2164

614 Peterson Rd
Burlington, WA 98233
Phone (360) 757-0131

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1225449929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 LAKEWAY DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255233",
            "telephone_number": "360-676-2187",
            "fax_number": "360-676-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 PETERSON RD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982332606",
            "telephone_number": "360-757-0131",
            "fax_number": "360-757-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "THELEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "COMPLIANCE & POLICY ANALYST",
        "authorized_official_telephone_number": "253-761-3898"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "29164800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlington Recovery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.