Proactive Supportive Housing Services, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PROACTIVE SUPPORTIVE HOUSING SERVICES, INC.

Practice address

218 N 3Rd St
Shelton, WA 98584-3502

Phone

(360) 952-3997

NPI assigned

Jan 30, 2023

Organization subpart

Yes

Parent organization

PROACTIVE SUPPORTIVE HOUSING SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Michele Baumgart

Title

Vice President

Phone

(360) 952-3997

Specialties & licenses 1

Addresses

Part of

Proactive Supportive Housing Services Inc

Locations

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1831805134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1115",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985840936",
            "telephone_number": "360-952-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N 3RD ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843502",
            "telephone_number": "360-952-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE SUPPORTIVE HOUSING SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROACTIVE SUPPORTIVE HOUSING SERVICES, INC.",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "BAUMGART",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "360-952-3997"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laciel Porter
• Amanda Porto, CDPT
• Adelle Pouliot, A.S., A.A.C., CPC
• Justin Allen Powers
• Thomas Russell Prieskorn, PA-C
• Jennifer Joline Proctor
• Providence Health & Services - Washington (Providence St. Peter Chemical Dependency Center)
• Providence Health & Services Washington (Providence St Peter Hospital)
• Valerie Pruett
• Kate Przybycien, RD

• Case Management Agency in Shelton, WA
• Providers in Shelton, WA by specialty
• Case Management Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.