NPIMap

Organization Active NPI

Lydia Place a Nonprofit Corporation

Doing business as Lydia Place

  • Community/Behavioral Health Agency
  • Bellingham, WA
National Provider Identifier
1508342759
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LYDIA PLACE A NONPROFIT CORPORATION
Doing business as
Lydia Place
Practice address
1430 North Garden Street
Bellingham, WA 98226
Phone
(360) 671-7663
Fax
(360) 933-9739
NPI assigned
Jul 11, 2018
Last updated
Mar 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Authorized official

Name
Erin Smith, LICSWNPI 1932461266
Title
Clinical Director
Phone
(360) 671-7663

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1430 North Garden Street
Bellingham, WA 98226

Mailing address

PO Box 28487
Bellingham, WA 98228
Phone (360) 671-7663

Other names 1

  • Lydia Place Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200220001811 WA Part B Supplier - Clinic/Group Practice 9739516352 Receives reassigned benefits from 5 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

1430 N Garden St
Bellingham, WA 98225
Phone (360) 671-7663

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1508342759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28487",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98228",
            "telephone_number": "360-671-7663",
            "fax_number": "360-933-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 NORTH GARDEN STREET",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-671-7663",
            "fax_number": "360-933-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA PLACE A NONPROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "360-671-7663",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lydia Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.