Seaside Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60512881 Issued in WA

Legal business name

SEASIDE PSYCHOTHERAPY LLC

Practice address

791 SE Fidalgo Ave Ste 101
Oak Harbor, WA 98277-5505

Phone

(360) 485-0980

NPI assigned

Oct 20, 2017

Organization subpart

No

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

Authorized official

Name

Charlotte MyersNPI 1144505553

Title

LCSW/Owner

Phone

(208) 404-3247

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlotte May Myers, LICSW

  • Social Worker
  • Elk, WA
  • NPI 1144505553
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1225549983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PARK AVE",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982778256",
            "telephone_number": "360-485-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 SE FIDALGO AVE STE 101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775505",
            "telephone_number": "360-485-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "208-404-3247"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60512881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sea Mar Community Health Centers
• Sea Mar Community Health Centers
• Sea Mar Community Health Centers
• Sea Mar Community Health Centers
• Christine Lee Sears, M.D.
• Seattle Vamc
• Alexandra Elaine Seelnacht
• Shaka Shakes, MSN
• Sarah Anne Sharp-Thomas, PHD
• Robert L Shelly, DC

• Clinical Social Worker in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.