Resilience Telepsychiatry & Wellness

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RESILIENCE TELEPSYCHIATRY & WELLNESS

Practice address

2105 112TH Ave NE Ste 201
Bellevue, WA 98004-2945

Phone

(425) 968-5948

NPI assigned

May 22, 2023

Organization subpart

No

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

Authorized official

Name

Keenan Smith, NPNPI 1003519372

Title

Pmhnp

Phone

(206) 249-7715

Specialties & licenses 6

Addresses

Practitioners 1

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

• Keenan Smith, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
  • NPI 1003519372
  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690070400000",
    "number": "1609568377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "206-249-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-968-5948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Howard St Ste R",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992010508",
            "country_code": "US",
            "telephone_number": "206-249-7715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESILIENCE TELEPSYCHIATRY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "206-249-7715",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Renne
• Cyrus Renninger
• Martin Molina Renteria, RBT, CBT
• Matt B Renton
• Elizabeth Brooke Repass, SCM
• Michael Resnick
• Resolve Therapy, LLC
• Resources
• Restart Professional Group, PLLC
• Restart Professional Group, PLLC

• Psychiatry Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.