Headspace Parking Lot PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HEADSPACE PARKING LOT PLLC

Practice address

76 Sund Rd
Elma, WA 98541-9119

Phone

(360) 929-0022

NPI assigned

Aug 1, 2023

Last updated

Nov 1, 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

Chrystal G Moore, ARNPNPI 1417434747

Title

Pmhnp

Phone

(757) 323-9104

Specialties & licenses 1

Addresses

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.

• Chrystal G Moore, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Federal Way, WA
  • NPI 1417434747
  NPD Authorized official

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1295417186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 SUND RD",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419119",
            "telephone_number": "360-929-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SUND RD",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419119",
            "telephone_number": "360-929-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADSPACE PARKING LOT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "757-323-9104",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Hannabas, M.D.
• James Emmett Hansen
• Elizabeth Harrington
• Marc Hartung
• Brandee Lee Haskin, PMHNP
• Bethany Healey
• Sally A Heath, MSW, LICSW, SUDP
• Marcus William Heisler, M.D.
• Rylan Hellstern
• Beverly McClure Hinson, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Elma, WA
• Providers in Elma, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.