Lisa C Bryden

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LW61485889 Issued in WA

Practice address

204 Custer Way SW Ste 103
Tumwater, WA 98501-3330

Phone

(360) 451-6497

NPI assigned

Feb 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa C Bobb Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 14, 2026 through Jan 14, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mind and Heart Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • Olympia, WA
  • NPI 1891524856

  Clinical

  NPD Authorized official
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  NPD
• Olympic Counseling Group

  • Professional Counselor
  • Lacey, WA
  • NPI 1649749458
  NPD (past)
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tumwater, WA
  • NPI 1679766620
  NPD (past)
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tumwater, WA
  • NPI 1841486339
  NPD (past)

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1841996683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CUSTER WAY SW STE 103",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985013330",
            "telephone_number": "360-451-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CUSTER WAY SW STE 103",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985013330",
            "telephone_number": "360-451-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYDEN",
        "first_name": "LISA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61485889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BOBB",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noraleen Pearl Brown
• Oakley Drew Brown, DC, MS, CCSP
• Adrian Elizabeth Bruton, DSW
• Wanda D Bryant-Johnson
• Haley Alene Bryant
• Kelly Buechel
• Hailey Burch
• Gayle Lindsey Burditt, MA CCC
• Betsy Enid Burgos Diaz, CHIR.CH.61363606
• Grace Elizabeth Burkhart, CDPT

• Social Worker in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.