Shades of Grace Emdr, Equine, Ifs Therapy, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SHADES OF GRACE EMDR, EQUINE, IFS THERAPY, PLLC

Practice address

599 NW Walker Rd
Poulsbo, WA 98370-8140

Phone

(360) 451-9253

NPI assigned

Nov 18, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Renee Miller, PSYD, LMFTNPI 1578619409

Title

Owner, Clinician, Provider

Phone

(360) 451-9253

Specialties & licenses 2

Addresses

Practitioners 1

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

• Renee G Miller, PSYD, LMFT

  • Marriage & Family Therapist
  • Poulsbo, WA
  • NPI 1578619409
  NPD Authorized official

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1609585595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 NW WALKER RD",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708140",
            "telephone_number": "360-451-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 NW WALKER RD",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708140",
            "telephone_number": "360-451-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADES OF GRACE EMDR, EQUINE, IFS THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER, CLINICIAN, PROVIDER",
        "authorized_official_telephone_number": "360-451-9253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Arne Selbyg, O.D.
• Shelly Self, DMD
• Marcela Serocki
• Donald James Setter, DO
• SFH Diagnostics LLC
• Kyan Shaffner, MA
• Shalom Hospice of Puget Sound LLC
• Sheila Andrews Inc
• Sheila C Lally, DO, PS
• Shelly Self DMD PLLC

• Mental Health Counselor in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.