Squareone Services, SPC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SQUAREONE SERVICES, SPC

Doing business as

Square One
Square One Recovery

Practice address

21300 68TH Ave W Ste 105
Lynnwood, WA 98036-7310

Phone

(425) 412-3155

Fax

(425) 249-3522

NPI assigned

Oct 4, 2018

Organization subpart

No

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

Authorized official

Name

Jessica Whitehead

Title

Ceo

Phone

(425) 412-3155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Square One Doing business as
• Square One Recovery Doing business as

Locations

Practitioners 3

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

• Amy Hofeditz, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Lynnwood, WA
  • NPI 1972156636
  NPD
• Elizabeth Boudreaux

  • Mental Health Counselor
  • Lynnwood, WA
  • NPI 1689142960
  NPD (past)
• Michal Waldfogel, ND

  • Naturopath
  • Seattle, WA
  • NPI 1689179202
  NPD (past)

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1730654849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 68TH AVE W STE 105",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367310",
            "telephone_number": "425-412-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 68TH AVE W STE 105",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367310",
            "telephone_number": "425-412-3155",
            "fax_number": "425-249-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUAREONE SERVICES, SPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-412-3155"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125346",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Square One",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Square One Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristopher Adam Spinning, MD
• Spokane Digestive Disease Center, P.S.
• Maya Sophia Sprague, MA, LMHC
• Mary V Springer, RN
• Springhealth Behavioral Health and Integrated Care Washington, LLC
• Jennifer Lynn Squire, DPT
• Savita Srivastava
• Kabal Sriviboon
• Josephine Mojica St Hilaire
• Cheryl Ann St Sauver

• Community/Behavioral Health Agency in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.