NPIMap

Organization Active NPI

Silverdale Psychiatric Services LLC

  • Clinical Psychologist
  • Gig Harbor, WA
National Provider Identifier
1437447208
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LH00003850 Issued in WA
Legal business name
SILVERDALE PSYCHIATRIC SERVICES LLC
Practice address
7191 Wagner Way NW
Suite 301
Gig Harbor, WA 98335-6909
Phone
(253) 514-8076
Fax
(253) 514-8078
NPI assigned
Jul 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Carole Heine, LMHC
Title
Owner/Provider
Phone
(253) 588-7911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X LH00003850 WA Primary

Addresses

Primary practice location

7191 Wagner Way NW
Suite 301
Gig Harbor, WA 98335-6909

Mailing address

PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911

Other identifiers 1

IdentifierTypeStateIssuer
LH00003850OtherWACAROLE'S MEDICAL LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Geary a Heine MD and Carole S Heinelmhc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1437447208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7191 WAGNER WAY NW",
            "address_2": "SUITE 301",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356909",
            "telephone_number": "253-514-8076",
            "fax_number": "253-514-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERDALE PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "253-588-7911",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "LH00003850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLE'S MEDICAL LICENSE",
            "identifier": "LH00003850",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.