EVERGREEN IN HOME MENTAL HEALTH (NPI# 1275066490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275066490 |
| Entity Type | Organization |
| Organization Name | EVERGREEN IN HOME MENTAL HEALTH |
| Practice Address |
12040 Ne 128th St Ms 74 Kirkland WA 98034-3013 |
| Practice Telephone | 4258996300 |
| Practice Fax Number | 4258996301 |
| Mailing Telephone | 4258996300 |
| Mailing Fax Number | 4258996301 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |
| Authorized Official Name | MRS. LEAH JONES (PROGRAM MANAGER) |
| Authorized Official Telephone | 4258996308 |
| Authorized Official Credential | SW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LH 60152884 | WA | Agencies |
| Street Address |
12040 NE 128TH ST MS 74 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-3013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225027428 | Suman L. Tewari | Obstetrics & Gynecology | 12040 Ne 128th St, Ms 105, Kirkland, WA 98034-3013 | 2005-10-19 |
| 1528674389 | Hannah Rose Narag Galvan | Registered Nurse | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-09-17 |
| 1942816970 | Julia Anne Baura Suico | Registered Nurse | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-09-16 |
| 1275147688 | Diana Dubinsky | Registered Nurse | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-09-02 |
| 1619599040 | Ana-irina Bologan | Registered Nurse | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-05-07 |
| 1467080499 | Suzanne Marie Campiche | Social Worker | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-03-27 |
| 1528694106 | Jordan Daryoush Kamal | Registered Nurse | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2020-03-16 |
| 1689224727 | Patricia Duenas Morgan | Nurse Practitioner | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2019-09-19 |
| 1700351533 | Katherine Claire Newman | Pharmacist | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2018-10-08 |
| 1104337682 | Kristin Bainbridge | Speech-Language Pathologist | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2017-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215288543 | Cadence Child and Adolescent Therapy | Community/Behavioral Health | 5210 Carillon Pt, Kirkland, WA 98033-7378 | 2012-09-26 |
| 1972955029 | Endeavor Family Counseling | Community/Behavioral Health | 9757 Ne Juanita Dr, Suite 300, Kirkland, WA 98034-4299 | 2016-07-12 |
| 1558716548 | Lionrock Behavioral Health, Inc | Community/Behavioral Health | 11335 Ne 122nd Way, Suite 105, Kirkland, WA 98034 | 2016-04-27 |
| 1992020044 | Northwest Center for Change | Community/Behavioral Health | 10512 Ne 68th St, Suite 202, Kirkland, WA 98033-7002 | 2010-04-01 |
| 1538213327 | King County Public Hospital District No. 2 | Community/Behavioral Health | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821539 | Cpf Breakthrough, LLC | Community/Behavioral Health | 11711 E Sprague Ave Ste D4, Spokane Valley, WA 99206-6122 | 2020-11-03 |
| 1538760111 | Nw Family Recovery Solutions | Community/Behavioral Health | 710 Bay St, Port Orchard, WA 98366-5310 | 2020-11-02 |
| 1891395091 | Art Nelson LLC | Community/Behavioral Health | 18679 15th Loop Ne, Poulsbo, WA 98370-7436 | 2020-10-27 |
| 1508463803 | Kim Lampson Pllc | Community/Behavioral Health | 9725 Se 36th St Ste 301, Mercer Island, WA 98040-3840 | 2020-10-08 |
| 1518573971 | Olive Crest | Community/Behavioral Health | 10125 Frontier Pl Nw, Silverdale, WA 98383-9408 | 2020-09-21 |
| 1659980563 | Deborah M Connors Pllc | Community/Behavioral Health | 534 Ne Everett St Ste 201, Camas, WA 98607-2025 | 2020-07-27 |
| 1790393221 | Charmd Behavioral & Health LLC | Community/Behavioral Health | 4318 233rd Pl Se, Bothell, WA 98021-9057 | 2020-07-21 |
| 1699392548 | Ryan Wathne Pllc | Community/Behavioral Health | 2711 E Madison St Ste 203, Seattle, WA 98112-4763 | 2020-06-26 |
| 1184241192 | Optimum Counseling, LLC | Community/Behavioral Health | 10710 Ne 10th St Apt 108, Bellevue, WA 98004-1033 | 2020-06-25 |
| 1467079467 | Recovery Cafe of Clark County | Community/Behavioral Health | 3312 E Fourth Plain Blvd Ste 100, Vancouver, WA 98661-5489 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EVERGREEN IN HOME MENTAL HEALTH.
| 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.