MYRIAM MAMPENGU (NPI# 1104380120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104380120 |
| Entity Type | Individual |
| Full Name | MYRIAM MAMPENGU |
| Practice Address |
6103 Mount Tacoma Dr Sw Lakewood WA 98499-2727 |
| Practice Telephone | 2532633221 |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | 60922600 | WA | Other Service Providers |
| Street Address |
6103 MOUNT TACOMA DR SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-2727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265654958 | Avalon Clinic | Clinic/Center | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2007-05-03 |
| 1699381012 | Ereke D Bruce | Social Worker | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2020-09-21 |
| 1710590831 | Olivia Noelle Domingo | Social Worker | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2020-08-28 |
| 1881218139 | Daisy Veronica Ortiz | Social Worker | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2020-06-02 |
| 1295209302 | Amanda Nicholson | Counselor | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2019-01-11 |
| 1104323443 | Jacqueline May | Counselor | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2018-04-12 |
| 1154672137 | David Ekland | Specialist | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2012-10-01 |
| 1255544540 | Avalon Clinic | Clinic/Center | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2007-05-07 |
| 1164635454 | Avalon Clinic | Clinic/Center | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2007-05-07 |
| 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 | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629604293 | Colorado Home Care Services LLC | Case Manager/Care Coordinator | 895 Brentwood St, Lakewood, CO 80214-4451 | 2020-03-16 |
| 1023672185 | Laura Macalik | Case Manager/Care Coordinator | 725 Airport Rd Ste 2, Lakewood, NJ 08701-5968 | 2019-04-24 |
| 1164998282 | Milenia Ods LLC | Case Manager/Care Coordinator | 2 Sienna Way, Lakewood, NJ 08701-2148 | 2018-10-16 |
| 1619479441 | Jacob House | Case Manager/Care Coordinator | 13420 W Warren Ave, Lakewood, CO 80228-4616 | 2018-03-07 |
| 1831549203 | Diana Lynne Fox | Case Manager/Care Coordinator | 2125 S Ammons St, Lakewood, CO 80227-2409 | 2016-06-16 |
| 1295068146 | Monica Michelle Sheleay | Case Manager/Care Coordinator | 12350 Del Amo Blvd, #2516, Lakewood, CA 90715-1732 | 2009-09-10 |
| 1497914261 | Sarah Mary Shaw | Case Manager/Care Coordinator | 7133 W Virginia Ave Apt 302, Lakewood, CO 80226-3159 | 2008-06-05 |
| 1497952097 | Brandt Joseph Vansickle | Case Manager/Care Coordinator | 1370 Ames St, Lakewood, CO 80214-2218 | 2007-06-28 |
| 1578783106 | Danielle Renee' Sikula | Case Manager/Care Coordinator | 17815 Northwood Ave, Lakewood, OH 44107-2225 | 2007-04-26 |
| 1407482508 | Ramy Elsawah | Case Manager/Care Coordinator | 1215 Route 70 Ste 2001, Lakewood, NJ 08701-7023 | 2020-03-20 |
| 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.