NPIMap

Organization Active NPI

Quileute Counseling and Recovery Mental Health

  • Mental Health Counselor
  • La Push, WA
National Provider Identifier
1225596232
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
QUILEUTE COUNSELING AND RECOVERY MENTAL HEALTH
Doing business as
Quileute Counseling and Recovery Mental Health
Practice address
560 Quileute Heights Loop
La Push, WA 98350
Phone
(360) 374-3358
NPI assigned
Mar 8, 2019
Last updated
Mar 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
QUILEUTE TRIBAL COUNCILAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Authorized official

Name
Gary Bryan Goodwin
Title
Billing Agency
Phone
(360) 867-0709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

560 Quileute Heights Loop
La Push, WA 98350

Mailing address

PO Box 189
La Push, WA 98350-0189
Phone (360) 374-3358

Other names 1

  • Quileute Counseling and Recovery Mental Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quileute Tribal Council4 organizations share this tax ID, including this one
Part of
Quileute Tribal Council

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1225596232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "LA PUSH",
            "state": "WA",
            "postal_code": "983500189",
            "telephone_number": "360-374-3358",
            "fax_number": "360-374-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 QUILEUTE HEIGHTS LOOP",
            "city": "LA PUSH",
            "state": "WA",
            "postal_code": "98350",
            "telephone_number": "360-374-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUILEUTE COUNSELING AND RECOVERY MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUILEUTE TRIBAL COUNCIL",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "BILLING AGENCY",
        "authorized_official_telephone_number": "360-867-0709"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quileute Counseling and Recovery Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Push, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.