Cascade Recovery Resource Center, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

602292 Issued in WA

Legal business name

CASCADE RECOVERY RESOURCE CENTER, LLC

Practice address

707 N Pearl St
Suite D
Ellensburg, WA 98926-2938

Phone

(509) 933-3838

Fax

(509) 933-4044

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Pam Stoneburg, CDP, NCACI

Title

Program Administrator

Phone

(509) 933-3838

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720127095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N PEARL ST",
            "address_2": "SUITE D",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989262938",
            "telephone_number": "509-933-3838",
            "fax_number": "509-933-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N PEARL ST",
            "address_2": "SUITE D",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989262938",
            "telephone_number": "509-933-3838",
            "fax_number": "509-933-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE RECOVERY RESOURCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONEBURG",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "509-933-3838",
        "authorized_official_credential": "CDP, NCACI"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "602292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995299",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.