Individual provider Active NPI

Stephen Cavender, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Omak, WA
National Provider Identifier
1265878417
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60214880 Issued in WA
Practice address
1007 Koala Dr.
Omak, WA 98841
Phone
(509) 826-6191
Fax
(509) 826-8416
NPI assigned
May 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60214880 WA Primary

Addresses

Primary practice location

1007 Koala Dr.
Omak, WA 98841

Mailing address

1007 Koala Dr.
Omak, WA 98841
Phone (509) 826-6191

Other identifiers 1

IdentifierTypeStateIssuer
CP60214880OtherWACHEMICAL DEPENDENCY PROFESSIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CP60214880WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindcare Solutions of Texas PA PastSince Aug 4, 2021 Accepting new patients
Okanogan Behavioral Healthcare Addiction (Substance Use Disorder) PastSince Jul 1, 2002 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1265878417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 KOALA DR.",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "98841",
            "telephone_number": "509-826-6191",
            "fax_number": "509-826-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 KOALA DR.",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "98841",
            "telephone_number": "509-826-6191",
            "fax_number": "509-826-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVENDER",
        "first_name": "STEPHEN",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60214880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHEMICAL DEPENDENCY PROFESSIONAL LICENSE",
            "identifier": "CP60214880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.