NPIMap

Organization Active NPI

University of Washington

Doing business as UW Psychological Services & Training Ctr

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seattle, WA
National Provider Identifier
1861824211
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
H-128 Issued in WA
Legal business name
UNIVERSITY OF WASHINGTON
Doing business as
UW Psychological Services & Training Ctr
Practice address
3920 15TH Ave NE
Uw Mailstop 351635
Seattle, WA 98195-1635
Phone
(206) 543-6511
Fax
(206) 616-8367
NPI assigned
Aug 7, 2013
Last updated
Aug 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Authorized official

Name
Dr. Corey N Fagan, PH.D.NPI 1851417927
Title
Clinic Director
Phone
(206) 543-6511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X H-128 WA Primary

Addresses

Primary practice location

3920 15TH Ave NE
Uw Mailstop 351635
Seattle, WA 98195-1635

Mailing address

1959 NE Pacific St
Uw Mailstop 351635
Seattle, WA 98195-0001
Phone (205) 543-6511

Other names 1

  • UW Psychological Services & Training Ctr Doing business as

National Provider Directory

National Provider Directory
Tax ID family
U of W Speech Hear CL48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1959 NE Pacific St
#351635
Seattle, WA 98195

3920 15th Ave NE
#351635
Seattle, WA 98195
Phone (206) 543-6511

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1861824211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "UW MAILSTOP 351635",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "205-543-6511",
            "fax_number": "206-616-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 15TH AVE NE",
            "address_2": "UW MAILSTOP 351635",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981951635",
            "telephone_number": "206-543-6511",
            "fax_number": "206-616-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "206-543-6511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WA",
            "license": "H-128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Psychological Services & Training Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.