Eidens Therapy Group

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EIDENS THERAPY GROUP

Doing business as

Betrayed Families
Maple Valley Family Therapy

Practice address

23852 232ND CT SE
Maple Valley, WA 98038-5216

Phone

(253) 569-3256

NPI assigned

Apr 2, 2021

Last updated

Apr 9, 2021By 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

Jessica Lynn Eidens, LMHCNPI 1770857518

Title

Founder

Phone

(253) 569-3256

Specialties & licenses 1

Addresses

Other names 2

• Betrayed Families Doing business as
• Maple Valley Family Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Lynn Eidens, LMHC

  • Mental Health Counselor
  • Maple Valley, WA
  • NPI 1770857518
  NPD Authorized official

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1710566237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 833",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980380833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23852 232ND CT SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385216",
            "telephone_number": "253-569-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EIDENS THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "EIDENS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "253-569-3256",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Betrayed Families",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maple Valley Family Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Dean Donovan, D.C.
• Jeffrey Doornbos, PHARMD
• Kristen Elizabeth Drury, PA-C
• Caitlyn Dungan, BS
• Joshua Ross Dunlap, RN
• Jessica Lynn Eidens, LMHC
• Empire of Daft Anesthesia, LLC
• Olivia Rose Englund, BCBA
• Wayne M Engstrom, R.PH.
• Kyle G. Erickson, M.S., LMFT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Maple Valley, WA
• Providers in Maple Valley, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.