Gina Nicole Bartucca Van Dyken, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG61112274 Issued in WA

Practice address

1601 E Fourth Plain Blvd BLDG 17
Vancouver, WA 98661-3717

Phone

(360) 397-8246

Fax

(360) 397-8250

NPI assigned

Nov 30, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1659975787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1678",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD BLDG 17",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "360-397-8246",
            "fax_number": "360-397-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTUCCA VAN DYKEN",
        "first_name": "GINA",
        "middle_name": "NICOLE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61112274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael M Barsotti, MD
• Jamie Lee Bartel
• Tara Louise Bartel
• Alyssa A Barto, M.D.
• Dorota Bozena Barton, CCC-SLP
• Zoe Bartynski, MD
• Ayla Barzallo
• Paniz Barzegari Sisan, DDS
• Dina Basarab, LCSW
• Firas Omar Basha, O.D.

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, 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 30, 2020; 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.