NPIMap

Organization Active NPI

Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kennewick, WA
National Provider Identifier
1447329529
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LUTHERAN COMMUNITY SERVICES NORTHWEST
Practice address
3321 West Kennewick Avenue
Suite 150
Kennewick, WA 99336
Phone
(509) 735-6446
Fax
(509) 735-6449
NPI assigned
Nov 6, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Shelia Clark
Title
Credentialing Specialist
Phone
(541) 201-3973

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Mental Health Counselor 101YM0800X WA
Social Worker 104100000X WA

Addresses

Primary practice location

3321 West Kennewick Avenue
Suite 150
Kennewick, WA 99336

Mailing address

3321 West Kennewick Avenue
Suite 150
Kennewick, WA 99336
Phone (509) 735-6446

Other practice location 1

5710 Bedford St
Pasco, WA 99301-8214
Phone (509) 735-6446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050408000542 WA Part B Supplier - Clinic/Group Practice 1254237522 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA; Seatac, WA; Kennewick, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Community SVCS NW17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

5710 Bedford St
Pasco, WA 99301
Phone (509) 735-6446

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1447329529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 WEST KENNEWICK AVENUE",
            "address_2": "SUITE 150",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-735-6446",
            "fax_number": "509-735-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 WEST KENNEWICK AVENUE",
            "address_2": "SUITE 150",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-735-6446",
            "fax_number": "509-735-6449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5710 Bedford St",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993018214",
            "country_code": "US",
            "telephone_number": "509-735-6446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUTHERAN COMMUNITY SERVICES NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "541-201-3973"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.