Blue Mountain Behavioral Health PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

BLUE MOUNTAIN BEHAVIORAL HEALTH PLLC

Practice address

6711 Regents Blvd Ste B
University Place, WA 98466-5421

Phone

(253) 240-1964

NPI assigned

Jan 13, 2023

Last updated

Sep 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura M Ibarra, LMFT LMHC SUDPNPI 1619133931

Title

Owner/Provider

Phone

(253) 240-1964

Specialties & licenses 2

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, and the practitioner matching its NPPES authorized official.

• Laura M Ibarra, MA, LMFT, LMHC, MAC

  • Addiction (Substance Use Disorder) Counselor
  • Tacoma, WA
  • NPI 1619133931
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1255046231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 REGENTS BLVD STE B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665421",
            "telephone_number": "253-240-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 REGENTS BLVD STE B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665421",
            "telephone_number": "253-240-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "IBARRA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "253-240-1964",
        "authorized_official_credential": "LMFT LMHC SUDP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Bishop, LMT, NCMMT
• Christine Blackburn, FNP-C
• Timothy Earl Blair
• Ahmear T Bland
• Kyle Travis Blevins, RN
• Blue Peacock Acupuncture LLC
• Bluestone Wellness PLLC (Bluestone Wellness)
• David D Bluhm, CST
• Bodywise Massage Inc
• Richard Bohnemann, PA-C

• Marriage & Family Therapist in University Place, WA
• Providers in University Place, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.