Lisa a Jungclas PH D Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00002518 Issued in WA

Legal business name

LISA A JUNGCLAS PH D INC

Practice address

12 Bellwether Way Ste 220
Bellingham, WA 98225-2914

Phone

(360) 734-7310

Fax

(360) 647-8336

NPI assigned

Sep 1, 2009

Organization subpart

No

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

Authorized official

Name

Lori Peters

Title

Office Manager

Phone

(360) 734-7310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Lisa A. Jungclas, PHD

  • Clinical Psychologist
  • Bellingham, WA
  • NPI 1598858599
  Medicare reassignment NPD

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1508099060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY",
            "address_2": "STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-734-7310",
            "fax_number": "360-647-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252914",
            "telephone_number": "360-734-7310",
            "fax_number": "360-647-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A JUNGCLAS PH D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-734-7310"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.