MR. VINCENT THOMAS GOLLOGLY (NPI# 1043686991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043686991 |
| Entity Type | Individual |
| Full Name | MR. VINCENT THOMAS GOLLOGLY |
| Credential | PH.D. |
| Practice Address |
11444 Gravelly Lake Dr Sw Lakewood WA 98499-1404 |
| Practice Telephone | 2532232525 |
| Mailing Telephone | 2532232525 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY00002233 | WA | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
PY00002233 | WA | Behavioral Health & Social Service Providers |
| Street Address |
11444 GRAVELLY LAKE DR SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
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| 1548723190 | Jennifer Durst | Psychologist | 445 Union Blvd Ste 221, Lakewood, CO 80228-1241 | 2019-04-10 |
| 1093296261 | Kendra A Mathys Psyd LLC | Psychologist | 15644 Madison Ave Ste 202, Lakewood, OH 44107-5622 | 2018-08-27 |
| 1285137703 | Empower Health Center | Psychologist | 195 Walnut Ave, Lakewood, NJ 08701-5669 | 2018-03-11 |
| 1639607336 | Reine Evereteze, Psyd, LLC | Psychologist | 8015 W Alameda Ave Ste 230, Lakewood, CO 80226-3076 | 2017-05-25 |
| 1710390299 | Mark Onusko | Psychologist | 2085 Wyandotte Ave, Lakewood, OH 44107-6135 | 2014-06-03 |
| 1093126369 | Elizabeth Ormond Ahlers | Psychologist | 1687 Cole Blvd Ste 103, Lakewood, CO 80401-3318 | 2014-05-08 |
| 1114346343 | Meshkin B Amirirad | Psychologist | 1492 S Jellison St, Lakewood, CO 80232-5025 | 2014-04-15 |
| 1588005060 | Marnel Kae Tucker | Psychologist | 4237 Palo Verde Ave, Lakewood, CA 90713-3219 | 2013-07-11 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.