Come Alive Youth Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COME ALIVE YOUTH SERVICES, LLC

Practice address

3367 NE Iverson Rd
Poulsbo, WA 98370-8803

Phone

(360) 731-9884

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

David SecrestNPI 1932335072

Title

Owner/Therapist

Phone

(360) 731-9884

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.

• David Scott Secrest, M.A.

  • Marriage & Family Therapist
  • Poulsbo, WA
  • NPI 1932335072
  NPD Authorized official

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1336788447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3367 NE IVERSON RD",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708803",
            "telephone_number": "360-731-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3367 NE IVERSON RD",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708803",
            "telephone_number": "360-731-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COME ALIVE YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "SECREST",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "360-731-9884"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Glass Collins, PHD
• Lacey M Collins, LMP
• Margaret Colson, NP
• Alexander Nathaniel Combs-Bachmann, DO
• Cherese Combs, DNP
• Complete Sleep Solutions LLC
• Sally L Conrad, PA-C
• Elias Cook, DPT
• Janet R. Cook, RPH..
• Joan M. Cook, P.T.

• Mental Health Counselor in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.