NPIMap

Organization Active NPI

Telecare Mental Health Services of Washington, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Tumwater, WA
National Provider Identifier
1730532136
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC.
Practice address
3285 Ferguson St SW
Tumwater, WA 98512-6192
Phone
(360) 943-1907
Fax
(360) 943-1932
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Lorena Lopez
Title
Provider Relations Supervisor
Phone
(510) 747-0552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

3285 Ferguson St SW
Tumwater, WA 98512-6192

Mailing address

1080 Marina Village Parkway
Suite 100
Alameda, CA 94501-1078
Phone (510) 337-7950

Other names 1

  • Telecare Tumwater E and T Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100603000217 WA Part B Supplier - Clinic/Group Practice 5698804409 Receives reassigned benefits from 77 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vancouver, WA; Tumwater, WA; McCleary, WA; Tukwila, WA; Tacoma, WA; Shelton, WA; Sedro Woolley, WA; Olympia, WA…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2118806Telecare Tumwater E and T3285 Ferguson St SW, Tumwater, WA 98512Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Telecare Mental Health Services of Washington Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

3285 Ferguson St SW
Tumwater, WA 98512
Phone (360) 252-2989

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1730532136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 FERGUSON ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126192",
            "telephone_number": "360-943-1907",
            "fax_number": "360-943-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "510-747-0552"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telecare Tumwater E and T",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.