Organization Active NPI

Heramba Mental Healthcare, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kent, WA
National Provider Identifier
1265150478
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HERAMBA MENTAL HEALTHCARE, PLLC
Practice address
1314 Central Ave S Ste 203
Kent, WA 98032-7430
Phone
(888) 867-0204
Fax
(888) 867-2165
NPI assigned
Aug 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Dr. Tchido Yao, DNP
Title
Arnp/Owner
Phone
(888) 867-0204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1314 Central Ave S Ste 203
Kent, WA 98032-7430

Mailing address

1314 Central Ave S Ste 203
Kent, WA 98032-7430
Phone (888) 867-0204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@herambamentalhc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231128002285 WA Part B Supplier - Clinic/Group Practice 0749647857 Receives reassigned benefits from 3 practitioners
Practice locations: Kent, WA

National Provider Directory

National Provider Directory

Locations

1314 Central Ave S
#203
Kent, WA 98032

1314 Central Ave S
Ste 203
Kent, WA 98032
Phone (888) 867-0204

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1265150478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 CENTRAL AVE S STE 203",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980327430",
            "telephone_number": "888-867-0204",
            "fax_number": "888-867-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 CENTRAL AVE S STE 203",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980327430",
            "telephone_number": "888-867-0204",
            "fax_number": "888-867-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERAMBA MENTAL HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "YAO",
        "authorized_official_first_name": "TCHIDO",
        "authorized_official_title_or_position": "ARNP/OWNER",
        "authorized_official_telephone_number": "888-867-0204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@herambamentalhc.com",
            "affiliation": "N",
            "address_1": "1314 Central Ave S Ste 203",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980327430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.