April D Bacongco, CNA
Individual provider Active NPI Counselor · Chehalis, WA
NPI 1265997704 · NPPES record last updated Feb 8, 2019
Key facts
- NPI
- 1265997704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- NC60590351 (WA)
- Practice address
- 500 SE Washington St
Chehalis, WA 98532 - Phone
- (509) 232-5766
- Fax
- (509) 321-5472
- NPI assigned
- Feb 8, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC60590351 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Behavioral Health Systems, Inc. | Past | Accepting new patients | |
| American Behavioral Health Systems, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NC60590351 | WA | Yes |
Addresses
Primary practice location
500 SE Washington St
Chehalis, WA 98532
Mailing address
12715 E Mission Ave
Spokane Valley, WA 99216-1027
Phone (509) 232-5766
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077844 | Medicaid | WA |
Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.