NPIMap

Organization Active NPI

Northstore Youth & Family SVCS

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bothell, WA
National Provider Identifier
1881735652
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NORTHSTORE YOUTH & FAMILY SVCS
Practice address
10309 Northeast 185TH Street
Bothell, WA 98011-3437
Phone
(425) 485-6541
Fax
(425) 485-4154
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bruce A Mulvey, MA
Title
Executive Director
Phone
(425) 485-6541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

10309 Northeast 185TH Street
Bothell, WA 98011-3437

Mailing address

10309 Northeast 185TH Street
Bothell, WA 98011-3437
Phone (425) 485-6541

National Provider Directory

National Provider Directory
Tax ID family
Northshore Youth and Family Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881735652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10309 NORTHEAST 185TH STREET",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113437",
            "telephone_number": "425-485-6541",
            "fax_number": "425-485-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10309 NORTHEAST 185TH STREET",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113437",
            "telephone_number": "425-485-6541",
            "fax_number": "425-485-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTORE YOUTH & FAMILY SVCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULVEY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-485-6541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.