TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC (NPI# 1275178360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275178360 |
| Entity Type | Organization |
| Organization Name | TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC |
| Practice Address |
307 W Cota St Shelton WA 98584-2265 |
| Mailing Address |
1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 |
| Practice Telephone | 5103377950 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |
| Authorized Official Name | LESLIE DAVIS (SVP, CFO) |
| Authorized Official Telephone | 5103377950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Telecare Shelton E&T | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790298347 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 33480 13th Pl S, Federal Way, WA 98003-6357 | 2017-11-06 |
| 1134737737 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 307 W Cota St, Shelton, WA 98584-2265 | 2020-07-20 |
| 1851859144 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 322 S Birch St, Mccleary, WA 98557-9522 | 2019-03-06 |
| 1932615630 | Telecare Mental Health Services of Washington, Inc | Clinic/Center | 3901 S Fife St Ste 301, Tacoma, WA 98409-7309 | 2017-12-18 |
| 1043741333 | Telecare Mental Health Services of Washington, Inc | Community/Behavioral Health | 9601 Steilacoom Blvd Sw, Bldg 27, Tacoma, WA 98498-7212 | 2017-03-27 |
| 1699162925 | Telecare Mental Health Services of Washington, Inc | Clinic/Center | 1601 E 4th Plain Blvd, Vancouver, WA 98661-3753 | 2015-04-24 |
| 1841504768 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 1601 E Fourth Plain Blvd, Building 17, Vancouver, WA 98661-3753 | 2010-08-03 |
| 1780913657 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 9601 Steilacoom Blvd Sw, Bldg 27, Tacoma, WA 98498-7212 | 2009-12-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | TELECARE MENTAL HEALTH SERVICES OF WASHINGTON, INC. | 1080 Marina Village Pkwy, Ste 100, Alameda, CA 94501 |
| Street Address |
307 W COTA ST |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933105 | Joshua Ireland | Psychologist | 307 W Cota St, Shelton, WA 98584-2265 | 2019-10-08 |
| 1528668787 | Ricardo De Jesus Funes | Social Worker | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-27 |
| 1841899713 | Mary Katherine Twidwell | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-22 |
| 1871191676 | Samantha Lynn Thompson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-14 |
| 1316559131 | Kerry Rose Johnson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-21 |
| 1013529122 | Jennifer A Sagen | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1629680731 | Akashia Milsap | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1457963571 | Shane Micheal Taylor | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1740890318 | Eric William Rehwaldt | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| 1013527654 | Tracy Lynn Wright | Licensed Practical Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737737 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 307 W Cota St, Shelton, WA 98584-2265 | 2020-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568936557 | Telecare Mental Health Services of Washington, Inc. | Psychiatric Residential Treatment Facility | 7224 Pacific Highway East, Milton, WA 98354 | 2019-01-14 |
| 1790298347 | Telecare Mental Health Services of Washington, Inc | Psychiatric Residential Treatment Facility | 33480 13th Pl S, Federal Way, WA 98003-6357 | 2017-11-06 |
| 1699223826 | Center for Discovery | Psychiatric Residential Treatment Facility | 2202 S Cedar St Ste 175, Tacoma, WA 98405-2318 | 2016-09-16 |
| 1730532136 | Telecare Mental Health Services of Washington, Inc. | Psychiatric Residential Treatment Facility | 3285 Ferguson St Sw, Tumwater, WA 98512-6192 | 2016-07-20 |
| 1922489392 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 7511 176th St Sw, Edmonds, WA 98026-5529 | 2015-06-11 |
| 1659758639 | Telecare Mental Health Services of Washington, Inc. | Psychiatric Residential Treatment Facility | 1803 N Sound Dr, Sedro Woolley, WA 98284-7697 | 2015-04-29 |
| 1780072900 | The Emily Program PC | Psychiatric Residential Treatment Facility | 7275 N. Mercer Way, Mercer Island, WA 98040 | 2014-12-23 |
| 1437554359 | Recovery Innovations, Inc | Psychiatric Residential Treatment Facility | 2150 Freeman Rd E Ste 1, Fife, WA 98424-3776 | 2014-11-04 |
| 1760796130 | Project Patch | Psychiatric Residential Treatment Facility | 2404 E Mill Plain Blvd Ste 4, Vancouver, WA 98661-4334 | 2010-07-28 |
| 1891950630 | Allen Douglas Webb Jr. | Psychiatric Residential Treatment Facility | 815 S Pearl, Pearl Street Center, Tacoma, WA 98465 | 2008-07-22 |
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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.