Susan Coolbaugh, Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

AP30004202 Issued in WA

Legal business name

SUSAN COOLBAUGH, INC

Practice address

6212 75TH St W
Lakewood, WA 98499-8368

Phone

(253) 983-8507

Fax

(253) 983-8576

NPI assigned

Mar 9, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Susan Frances Coolbaugh, ARNP

Title

President

Phone

(253) 983-8507

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1902129620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6212 75TH ST W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998368",
            "telephone_number": "253-983-8507",
            "fax_number": "253-983-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6212 75TH ST W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998368",
            "telephone_number": "253-983-8507",
            "fax_number": "253-983-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN COOLBAUGH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "COOLBAUGH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-983-8507",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WA",
            "license": "AP30004202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Adult Mental Health Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.