Intergenerational Healing and Wellness Collective

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTERGENERATIONAL HEALING AND WELLNESS COLLECTIVE

Doing business as

Intergenerational Healing and Wellness Collective

Practice address

1400 W Washington St Ste 24
Sequim, WA 98382-3236

Phone

(360) 590-1659

NPI assigned

Jul 31, 2023

Last updated

Jul 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Naeemah Johnson, LICSW

Title

Owner

Phone

(360) 590-1659

Specialties & licenses 1

Addresses

Other names 1

• Intergenerational Healing and Wellness Collective Doing business as

Locations

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1568143592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W WASHINGTON ST STE 24",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823236",
            "telephone_number": "360-590-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W WASHINGTON ST STE 24",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823236",
            "telephone_number": "360-590-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERGENERATIONAL HEALING AND WELLNESS COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NAEEMAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-590-1659",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intergenerational Healing and Wellness Collective",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Sequim, WA
• Providers in Sequim, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.