NPIMap

Organization Active NPI

Bhardra Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Woodinville, WA
National Provider Identifier
1487029708
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BHARDRA RECOVERY
Practice address
18500 156TH Ave NE
#300
Woodinville, WA 98072
Phone
(206) 957-0721
Fax
(206) 957-0723
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Jessica Carol Dark, SUDDNPI 1356785786
Title
Director, Owner
Phone
(206) 957-0721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 17 113800 WA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

18500 156TH Ave NE
#300
Woodinville, WA 98072

Mailing address

18500 156TH Ave NE
#300
Woodinville, WA 98072
Phone (206) 957-0721

Other names 1

  • CTC Counseling Services LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

12351 Lake City Way NE
Ste 202
Seattle, WA 98125

18500 156th Ave NE
Ste 300
Woodinville, WA 98072
Phone (206) 696-3140

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1487029708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18500 156TH AVE NE",
            "address_2": "#300",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "206-957-0721",
            "fax_number": "206-957-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18500 156TH AVE NE",
            "address_2": "#300",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "206-957-0721",
            "fax_number": "206-957-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHARDRA RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "DARK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "DIRECTOR, OWNER",
        "authorized_official_telephone_number": "206-957-0721",
        "authorized_official_credential": "SUDD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "17 113800",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CTC Counseling Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.