Cedar River Psychotherapy & Recovery LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LH00008596 Issued in WA

Legal business name

CEDAR RIVER PSYCHOTHERAPY & RECOVERY LLC

Practice address

119 Pelly Ave N
Renton, WA 98057-5714

Phone

(206) 388-8203

NPI assigned

Dec 19, 2014

Last updated

Dec 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Kay Moynihan, LMHC

Title

President

Phone

(206) 388-8203

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1437557691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "206-388-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "206-388-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RIVER PSYCHOTHERAPY & RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MOYNIHAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-388-8203",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "LH00008596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Renton, WA
• Providers in Renton, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.