NPIMap

Organization Active NPI

South Sound Behavior Therapy Corp

  • Community/Behavioral Health Agency
  • Olympia, WA
National Provider Identifier
1306184593
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTH SOUND BEHAVIOR THERAPY CORP
Practice address
3443 Lilly Rd NE
Olympia, WA 98506-3091
Phone
(360) 456-2237
Fax
(360) 456-2231
NPI assigned
Jan 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Jennica Kristine Warner, BCBANPI 1285872218
Title
Owner
Phone
(360) 456-2237

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3443 Lilly Rd NE
Olympia, WA 98506-3091

Mailing address

3443 Lilly Rd NE
Olympia, WA 98506-3091
Phone (360) 456-2237

Other practice location 1

9333 Martin Way E
Suite 214
Olympia, WA 98516-5969
Phone (808) 292-0784

National Provider Directory

National Provider Directory

Locations

3443 Lilly Rd NE
Olympia, WA 98506
Phone (360) 371-6250

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1306184593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063091",
            "telephone_number": "360-456-2237",
            "fax_number": "360-456-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063091",
            "telephone_number": "360-456-2237",
            "fax_number": "360-456-2231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 Martin Way E",
            "address_2": "Suite 214",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985165969",
            "country_code": "US",
            "telephone_number": "808-292-0784",
            "fax_number": "360-355-9089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH SOUND BEHAVIOR THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JENNICA",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-456-2237",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.