NPIMap

Organization Active NPI

Educational and Psychological Services

  • Case Management Agency
  • Clarkston, WA
National Provider Identifier
1891064606
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
LH 00011315 Issued in WA
Legal business name
EDUCATIONAL AND PSYCHOLOGICAL SERVICES
Practice address
629 6TH St
Clarkston, WA 99403-2010
Phone
(509) 758-9698
NPI assigned
Dec 22, 2011
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Jarod John FitzgeraldNPI 1477690576
Title
PHD
Phone
(509) 758-9698

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
Case Management Agency 251B00000X LH 00011315 WA Primary

Addresses

Primary practice location

629 6TH St
Clarkston, WA 99403-2010

Mailing address

629 6TH St
Clarkston, WA 99403-2010
Phone (509) 758-9698

National Provider Directory

National Provider Directory

Locations

629 6th St
Clarkston, WA 99403
Phone (509) 758-9698

Practitioners & affiliated clinicians

Practitioners 11

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1891064606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032010",
            "telephone_number": "509-758-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032010",
            "telephone_number": "509-758-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATIONAL AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JAROD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PHD",
        "authorized_official_telephone_number": "509-758-9698"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WA",
            "license": "LH 00011315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.