Island Assessment and Counseling Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

601 740 480 Issued in WA

Legal business name

ISLAND ASSESSMENT AND COUNSELING CENTER, INC.

Practice address

520 E Whidbey Ave Ste 205
Oak Harbor, WA 98277-5921

Phone

(360) 675-5782

Fax

(360) 675-9115

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Timothy E Liddle, MA, CDP, LMHC, MAC

Title

Owner

Phone

(360) 675-5782

Specialties & licenses 1

Addresses

Other names 1

• Island Assessment and Counseling Center, Inc. Other name

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1245355973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E WHIDBEY AVE STE 205",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775921",
            "telephone_number": "360-675-5782",
            "fax_number": "360-675-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E WHIDBEY AVE STE 205",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775921",
            "telephone_number": "360-675-5782",
            "fax_number": "360-675-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND ASSESSMENT AND COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "LIDDLE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-675-5782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, CDP, LMHC, MAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "601 740 480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Assessment and Counseling Center, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.