Jenais Radabaugh, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60793356 Issued in WA

Practice address

2626 12TH CT SW Ste 8
Olympia, WA 98502-1163

Phone

(360) 317-2254

Fax

(360) 203-0049

NPI assigned

Sep 9, 2014

Last updated

Apr 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1427459429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 12TH CT SW STE 8",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021163",
            "telephone_number": "360-317-2254",
            "fax_number": "360-203-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 12TH CT SW STE 8",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021163",
            "telephone_number": "360-317-2254",
            "fax_number": "360-203-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "JENAIS",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60793356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caitlin R Rabey, ARNP
• Holly M Rabisa, MA-P, AAC
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• Radically Empowered Nutrition
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• Psychologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.