NPIMap

Organization Active NPI

Columbia Wellness

  • Case Management Agency
  • Longview, WA
National Provider Identifier
1487659579
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COLUMBIA WELLNESS
Practice address
720 14TH Avenue
Longview, WA 98632-2316
Phone
(360) 423-0203
Fax
(360) 423-5086
NPI assigned
Jun 16, 2005
Last updated
Apr 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Authorized official

Name
Mr. Joseph Andrew McDanielNPI 1861551012
Title
Ceo
Phone
(360) 423-0203

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

720 14TH Avenue
Longview, WA 98632-2316

Mailing address

PO Box 1847
Longview, WA 98632-8140
Phone (360) 423-0203

Other identifiers 1

IdentifierTypeStateIssuer
1980903MedicaidWA

Other names 1

  • Cowlitz County Guidance Association Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000406 WA Part B Supplier - Clinic/Group Practice 2567358286 Receives reassigned benefits from 11 practitioners
Practice locations: Aberdeen, WA; Longview, WA

National Provider Directory

National Provider Directory

Locations

2700 Simpson Ave
Ste 101
Aberdeen, WA 98520
Phone (360) 612-0012

600 Broadway St
Ste 200
Longview, WA 98632

720 14th Ave
Longview, WA 98632

921 14th Ave
Longview, WA 98632

Practitioners & affiliated clinicians

Practitioners 341

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 341

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1487659579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328140",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322316",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-423-0203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980903",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cowlitz County Guidance Association",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Cowlitz County Guidance Association",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Longview, WA

Sources for this page

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