Individual provider Active NPI

Lama Alameddine, PSY

  • Cognitive & Behavioral Psychologist
  • Renton, WA
National Provider Identifier
1336695873
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
PY60687994 Issued in WA
Practice address
4033 Talbot Rd S Ste 520
Renton, WA 98055-5774
Phone
(425) 690-3586
Fax
(425) 690-9586
NPI assigned
Aug 25, 2016
Last updated
May 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY60687994 WA
Cognitive & Behavioral Psychologist 103TB0200X PY60687994 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 520
Renton, WA 98055-5774

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057-4970
Phone (425) 690-2715

Other practice location 1

400 S 43rd St
Renton, WA 98055-5714
Phone (425) 656-5566

Other identifiers 1

IdentifierTypeStateIssuer
2066322MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lalamaddine61796@direct.valleymed.org Direct
FHIR URL https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026000494 WA Practitioner - Clinical Psychologist 1658659636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Virginia School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brain and Memory Health Group PLLCGroup PAC ID 7012359300, 9 clinicians

Practice addresses (Care Compare)

4501 15TH Ave S
Suite 102
Seattle, WA 98108-1874
Phone (425) 494-3554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY60687994WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brain and Memory Health Group PLLC CurrentSince Jun 2, 2024 Accepting new patients
Valley Medical Group-Renton CurrentSince Sep 12, 2016 Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

3600 Lind Ave SW
Ste 100
Renton, WA 98057

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

4033 Talbot Rd S
Ste 520
Renton, WA 98055
Phone (425) 255-1999

4501 15th Ave S
Ste 102
Seattle, WA 98108
Phone (206) 552-8857

Interoperability endpoints

  • Direct secure messaging: lalamaddine61796@direct.valleymed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1336695873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 520",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555774",
            "telephone_number": "425-690-3586",
            "fax_number": "425-690-9586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S 43rd St",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555714",
            "country_code": "US",
            "telephone_number": "425-656-5566",
            "fax_number": "425-656-5567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALAMEDDINE",
        "first_name": "LAMA",
        "credential": "PSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60687994",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY60687994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2066322",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lalamaddine61796@direct.valleymed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lalamaddine61796@direct.valleymed.org",
            "address_1": "4033 Talbot Rd S Ste 520",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4033 Talbot Rd S Ste 520",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.