MS. JODI MARIE LIETZ (NPI# 1265733661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265733661 |
| Entity Type | Individual |
| Full Name | MS. JODI MARIE LIETZ |
| Credential | BA, CDP |
| Practice Address |
2500 Ne 65th Ave Vancouver WA 98661-6812 |
| Practice Telephone | 3607507500 |
| Mailing Telephone | 3607507500 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CP60145161 | WA | Behavioral Health & Social Service Providers |
| Street Address |
2500 NE 65TH AVE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98661-6812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952469074 | Jill A Layman | Physical Therapist | 2500 Ne 65th Ave, Vancouver, WA 98661 | 2006-12-04 |
| 1932708237 | Alexandra Brucculeri | Speech-Language Pathologist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2020-10-19 |
| 1972114304 | Adele Theresa Woods | Counselor | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2020-08-10 |
| 1053971556 | Levi John Vantol | Physical Therapist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2019-06-17 |
| 1952885725 | Leala Logan | Physical Therapist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2018-09-18 |
| 1417473604 | Elizabeth M Keeler | Physical Therapist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2017-08-18 |
| 1346764966 | Sara Schaaf | Speech-Language Pathologist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2017-07-26 |
| 1366996894 | Anna Waller | Speech-Language Pathologist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2016-08-12 |
| 1699130898 | Kayla Head | Speech-Language Pathologist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2015-12-15 |
| 1083004196 | Darcy Annabelle-basque Santero | Speech-Language Pathologist | 2500 Ne 65th Ave, Vancouver, WA 98661-6812 | 2015-01-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228417 | Cynthia Ann Holt | Social Worker | 4608 Ne 47 Street, Vancouver, WA 98661 | 2020-06-01 |
| 1235793027 | James Dostert | Counselor | 1601 E 4th Blvd. Bldg. 17, Ste A212, Vancouver, WA 98661 | 2019-04-26 |
| 1306305289 | Kathryn Susanne Scott | Social Worker | Attn: Kathryn Scott, V3cnh, 1601 E. Fourth Plain Blvd., Vancouver, WA 98661 | 2019-03-19 |
| 1952860637 | Alice Rogers | Occupational Therapist | Vancouver Public Schools, 2901 Falk Rd., Vancouver, WA 98661 | 2019-03-13 |
| 1053878538 | Paula Moore | Counselor | 9626 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2019-02-21 |
| 1558825729 | Cassandra Marie Nichols | Counselor | 1601 E 4th Blvd, Vancouver, WA 98661 | 2019-01-22 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
| 1023505229 | Ellen Barbour | Counselor | 1601 E 4th Plain Blvd Bldg. 17, Ste A212, Vancouver, WA 98661 | 2018-04-13 |
| 1679096325 | Brian Scott Coleman | Counselor | 1601 East Fourth Plain Blvd., Bldg #17, Ste. A212, Vancouver, WA 98661 | 2017-07-24 |
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| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669012332 | Beatriz Soto Martinez | Counselor | 6816 Ne 131st Ave Unit 128, Vancouver, WA 98682-4625 | 2020-01-10 |
| 1871140350 | Anthony Douglas Dejesus | Counselor | 4305 Ne Thurston Way Ste E, Vancouver, WA 98662-6655 | 2019-08-20 |
| 1235793027 | James Dostert | Counselor | 1601 E 4th Blvd. Bldg. 17, Ste A212, Vancouver, WA 98661 | 2019-04-26 |
| 1811460231 | Matthew Mcelveen | Counselor | 4000 Ne 94th St, Vancouver, WA 98665-5313 | 2019-01-08 |
| 1164910840 | Lucyann Kendall | Counselor | 4949 Ne St Johns Rd Apt 1, Vancouver, WA 98661-2536 | 2018-04-27 |
| 1609364413 | Amanda Boden | Counselor | 12503 Se Mill Plain Blvd Ste 119a, Vancouver, WA 98684-4007 | 2018-04-26 |
| 1023505229 | Ellen Barbour | Counselor | 1601 E 4th Plain Blvd Bldg. 17, Ste A212, Vancouver, WA 98661 | 2018-04-13 |
| 1922501998 | Carl Albert Robinson | Counselor | 1601 E Fourth Plain Blvd Bldg 17b222, Vancouver, WA 98661-3713 | 2018-03-15 |
| 1891200531 | Craig Goold | Counselor | 18908 Se 23rd St, Vancouver, WA 98683-9793 | 2017-12-04 |
| 1679096325 | Brian Scott Coleman | Counselor | 1601 East Fourth Plain Blvd., Bldg #17, Ste. A212, Vancouver, WA 98661 | 2017-07-24 |
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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.