Pacific Roots Mental Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PACIFIC ROOTS MENTAL HEALTH

Practice address

19125 N Creek Pkwy Ste 120
Bothell, WA 98011-8000

Phone

(425) 954-6796

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By 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

Melissa Coleen Mejias, LICSWNPI 1215091673

Title

Owner/Therapist

Phone

(425) 954-6796

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 2

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.

• Melissa Coleen Mejias, LICSW

  • Clinical Social Worker
  • Bothell, WA
  • NPI 1215091673
  NPD Authorized official
• Gena Palm

  • Clinical Social Worker
  • Issaquah, WA
  • NPI 1700338977
  NPD (past)

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1780303685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19125 N CREEK PKWY STE 120",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118000",
            "telephone_number": "425-954-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19125 N CREEK PKWY STE 120",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118000",
            "telephone_number": "425-954-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ROOTS MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "MEJIAS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "COLEEN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "425-954-6796",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE ISSUED UBI",
            "identifier": "604923091",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa@pacificroots.org",
            "affiliation": "N",
            "endpointDescription": "secure email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19125 N Creek Pkwy Ste 120",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980118000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abdullah Oz, MD
• Pacific Coast Wellness PLLC (Elite Chiropractic Northwest)
• Pacific Islamic Community and Cultural Services (PICACS Clinic)
• Pacific Medical Evaluations and Treatment Services, PLLC
• Pacific Mobile Foot Care PLLC
• Pacific Vascular Incorporated
• Pacific Vascular Incorporated
• Pacmed Clinics
• Pacmed Clinics
• Jacqueline Nicole Paiz

• Clinical Social Worker in Bothell, WA
• Providers in Bothell, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.