The Well Space Therapy, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

THE WELL SPACE THERAPY, PLLC

Practice address

23712 105TH St SE
Monroe, WA 98272-8748

Phone

(425) 409-9671

NPI assigned

Oct 27, 2022

Organization subpart

No

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

Authorized official

Name

Tahani Daugherty, LICSWNPI 1720486137

Title

Managing Member

Phone

(425) 409-9671

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.

• Tahani Alexis Daugherty, LICSW

  • Clinical Social Worker
  • Monroe, WA
  • NPI 1720486137
  NPD Authorized official

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1407563653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23712 105TH ST SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982728748",
            "telephone_number": "425-409-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23712 105TH ST SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982728748",
            "telephone_number": "425-409-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELL SPACE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "TAHANI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "425-409-9671",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Taylor, DPT
• Kristi Lynn Tekel, MA, CCC-SLP
• Evan Sidney Teplow, MD
• Julie Ann Teuber, MA. LMHCA
• The Smile Institute, LTD.
• Emma Marie Theisen, ND
• Therapeutic Associates Inc
• Theta Enterprises LLC
• Ameera S. Thomas, D.M.D.
• Rebekah Ruth Thompson, MA

• Adult Mental Health Clinic/Center in Monroe, WA
• Providers in Monroe, WA by specialty
• Adult Mental Health Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.