Gretchen H Van Bodegom

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61551656 Issued in WA

Practice address

922 S Cowley St Ste 9
Spokane, WA 99202-1263

Phone

(509) 822-6777

Fax

(509) 676-6655

NPI assigned

Dec 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundations Family Support LLC

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1083103238
  Medicare reassignment NPD
• Kent Youth and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kent, WA
  • NPI 1285837849
  NPD (past)
• Kent Youth and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kent, WA
  • NPI 1932399359
  NPD (past)

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1649938168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 S COWLEY ST STE 9",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021263",
            "telephone_number": "509-822-6777",
            "fax_number": "509-676-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 S COWLEY ST STE 9",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021263",
            "telephone_number": "509-822-6777",
            "fax_number": "509-676-6655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 2nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325862",
            "country_code": "US",
            "telephone_number": "253-859-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BODEGOM",
        "first_name": "GRETCHEN",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61551656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cori A Valley, LMHC
• Tanya L Valley, MSPT
• Emily Ann Vallies, SUDP
• Cristine Alexa Vallone, CDPT
• Vamc
• Robin Brady Van Bommel, MSSW,LCSW
• Jessica Marie Van Boven, LICSW
• Ean James Zahn Van Bramer, DO
• Miranda L Van de Loo, DNP, FNP-BC, PMHNP
• Olivia Van de Rostyne

• Mental Health Counselor in Spokane, WA
• Providers in Spokane, 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 Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.