NPIMap

Organization Active NPI

Sacred Dreams Counseling Center

  • Mental Health Counselor
  • Port Hadlock, WA
National Provider Identifier
1861045197
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SACRED DREAMS COUNSELING CENTER
Doing business as
Sacred Dreams Counseling Center
Practice address
11237 Rhody Dr Ste a
Port Hadlock, WA 98339-9749
Phone
(360) 385-1350
Fax
(360) 385-9600
NPI assigned
Jul 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

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

Authorized official

Name
Virginia R Nielsen, MANPI 1467834135
Title
Clinical Director
Phone
(360) 385-1350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

11237 Rhody Dr Ste a
Port Hadlock, WA 98339-9749

Mailing address

PO Box 1014
Chimacum, WA 98325-1014
Phone (603) 385-1350

Other identifiers 2

IdentifierTypeStateIssuer
214041MedicaidWA
1467834135MedicaidWA

Other names 1

  • Sacred Dreams Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

11237 Rhody Dr
Ste A
Port Hadlock, WA 98339
Phone (360) 385-1350

Practitioners & affiliated clinicians

Practitioners 1

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": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582934400000",
    "number": "1861045197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CHIMACUM",
            "state": "WA",
            "postal_code": "983251014",
            "telephone_number": "603-385-1350",
            "fax_number": "360-385-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11237 RHODY DR STE A",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "983399749",
            "telephone_number": "360-385-1350",
            "fax_number": "360-385-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED DREAMS COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "360-385-1350",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214041",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467834135",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Dreams Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sacred Dreams Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Hadlock, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.