Four Elements Behavioral Health Corp

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FOUR ELEMENTS BEHAVIORAL HEALTH CORP

Practice address

1104 Main St Ste M110
Vancouver, WA 98660-2980

Phone

(360) 695-1075

Fax

(360) 326-1736

NPI assigned

Jan 22, 2020

Last updated

Jan 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Goulding

Title

Billing Rep

Phone

(419) 565-7298

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1891325551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 MAIN ST STE M110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602980",
            "telephone_number": "360-695-1075",
            "fax_number": "360-326-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 MAIN ST STE M110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602980",
            "telephone_number": "360-695-1075",
            "fax_number": "360-326-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR ELEMENTS BEHAVIORAL HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "GOULDING",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "BILLING REP",
        "authorized_official_telephone_number": "419-565-7298"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Foucault, PHARMD
• Cherry V Foultner
• Foundational Therapy NW
• Carson Fountain
• Four Directions Counseling Center PC.
• Fourth Plain Forward
• Panagiotis Fourtounis, MD
• Danni Ann Marie Fowers
• Bart James Fowler, PSY.D.
• Debra L Fowler

• Mental Health Clinic/Center (Including Community Mental Health Center) in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.