CARL LANDERHOLM (NPI# 1194140228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194140228 |
| Entity Type | Individual |
| Full Name | CARL LANDERHOLM |
| Credential | LICSW |
| Practice Address |
2700 Simpson Ave Ste 101 Aberdeen WA 98520-4333 |
| Mailing Address |
Po Box 1847 Longview WA 98632-8140 |
| Practice Telephone | 3609060228 |
| Practice Fax Number | 3609060232 |
| Mailing Telephone | 3604230203 |
| Mailing Fax Number | 3605770269 |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2019-11-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LW60140440 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2129981 | 05 |
| Street Address |
2700 SIMPSON AVE STE 101 |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-4333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265077903 | Jaqueline Carrasco | Nurse's Aide | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2019-11-15 |
| 1629630033 | Robert Watkins | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2019-07-05 |
| 1003376195 | Kelli Alexander | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2019-03-23 |
| 1497227433 | Gabrielle Cummuta | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2018-12-31 |
| 1568942274 | Laurie Sturgill | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2018-08-21 |
| 1306333075 | Francisco J Caballero | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2018-04-18 |
| 1013423888 | Karroll Jean Styner | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2017-12-15 |
| 1982113585 | Joshua Cache Mccallum | Peer Specialist | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2017-09-26 |
| 1477071751 | Patrick Michael Mcdaniel | Counselor | 2700 Simpson Ave Ste 101, Aberdeen, WA 98520-4333 | 2017-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578191680 | Lisa Marie Wainwright | Social Worker | 82 Liberty St, Aberdeen, MD 21001-3821 | 2020-04-01 |
| 1518428580 | New Endeavors Counseling Associates | Social Worker | 20 Cambridge Dr Ste E, Aberdeen, NJ 07747-2256 | 2019-03-30 |
| 1528536257 | Lisa Patchell | Social Worker | 111 Mount Royal Ave, Aberdeen, MD 21001-2447 | 2018-11-12 |
| 1811407398 | Trisha Abbey | Social Worker | 1326 Tralee Circle, None, Aberdeen, MARYLAND 21001 | 2017-10-10 |
| 1043694375 | Elizabeth Brodie | Social Worker | 91 Avondale Ln, Aberdeen, NJ 07747-1239 | 2015-07-16 |
| 1811391931 | Maureen Hulse | Social Worker | 901 Barnett Ln, Aberdeen, MD 21001-1748 | 2014-10-17 |
| 1043656218 | Kristin R Mislak | Social Worker | 1040 Hardees Dr Ste F, Aberdeen, MD 21001-2665 | 2013-05-15 |
| 1013206705 | Alvin D. Wilson | Social Worker | 115 Ashleigh Blvd, Aberdeen, NC 28315 | 2011-04-01 |
| 1003142761 | Creative Concepts Therapeutic Services | Social Worker | 100 Pear St, Aberdeen, NC 28315-2924 | 2009-10-29 |
| 1790807709 | Robert R. Ramsey | Social Worker | 1210 Madison St, Aberdeen, WA 98520-2838 | 2007-04-03 |
| Find all providers in ABERDEEN | ||||
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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.