Crestview Psychological Services, P.S.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001993 Issued in WA

Legal business name

CRESTVIEW PSYCHOLOGICAL SERVICES, P.S.

Practice address

1610 Grover St
Suite D-1
Lynden, WA 98264-1539

Phone

(360) 398-8217

Fax

(360) 354-5399

NPI assigned

Dec 29, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Dale Brinkman, PSY.D.NPI 1265588255

Title

President

Phone

(360) 398-8127

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Dale Brinkman, PSY.D.

  • Clinical Psychologist
  • Lynden, WA
  • NPI 1265588255
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1992782015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982640331",
            "telephone_number": "360-398-8127",
            "fax_number": "360-354-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 GROVER ST",
            "address_2": "SUITE D-1",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641539",
            "telephone_number": "360-398-8217",
            "fax_number": "360-354-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW PSYCHOLOGICAL SERVICES, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-398-8127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colony House Furniture
• Kelly Cooper, LMHC
• Kaytlynn Robin Ella Corey
• Jeanne Crabtree, LMP
• Lisa D Creighton
• Kerri Cunningham
• Dan A Dahlberg, LMHC
• Alizee Dalton
• Marc Joel Davis, LMP
• Corrine Dejong, LMP

• Clinical Psychologist in Lynden, WA
• Providers in Lynden, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.