A CHANGE INTO RECOVERY, LLC (NPI# 1386019727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386019727 |
| Entity Type | Organization |
| Organization Name | A CHANGE INTO RECOVERY, LLC |
| Practice Address |
719 E Main Suite C Puyallup WA 98372-3306 |
| Practice Telephone | 2538418165 |
| Practice Fax Number | 2538418168 |
| Mailing Telephone | 2538418165 |
| Mailing Fax Number | 2538418168 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |
| Authorized Official Name | MR. DAVE HARRIS (ADMINISTRATOR) |
| Authorized Official Telephone | 2538418165 |
| Authorized Official Credential | CDP, NCAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | CP00002706 | WA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073984480 | A Change Into Recovery, LLC | Clinic/Center | 719 E Main Ave, Suite C, Puyallup, WA 98372 | 2015-10-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | A CHANGE INTO RECOVERY, LLC | 719 E Main, Puyallup, WA 98372-3306 |
| Street Address |
719 E MAIN SUITE C |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-3306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396868493 | Sound Counseling Inc | Clinic/Center | 719 E Main, Suite C, Puyallup, WA 98372-3306 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| 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 |
|---|---|---|---|---|
| 1487114385 | Summit Behavioral Solutions, LLC | Community/Behavioral Health | 4017 Crystal Ridge Dr Se, Puyallup, WA 98372-5261 | 2019-03-25 |
| 1962986117 | Honey Behavioral Therapy, Pllc | Community/Behavioral Health | 12811 80th Avenue Ct E, Puyallup, WA 98373-7700 | 2018-09-23 |
| 1003150202 | Sound Recovery Center, LLC | Community/Behavioral Health | 201 Valley Ave Nw, A, Puyallup, WA 98371-3305 | 2012-11-12 |
| 1235610023 | Share and Care House | Community/Behavioral Health | 702 23rd Ave Se, Puyallup, WA 98372-4661 | 2018-08-28 |
| 1952852972 | The Psych Spot | Community/Behavioral Health | 15406 Meridian E, Ste 208, Puyallup, WA 98375-9504 | 2016-10-14 |
| 1235580804 | Brooksby & Associates Pllc | Community/Behavioral Health | 15406 Meridian E Ste 103, Puyallup, WA 98375-9504 | 2016-06-24 |
| 1003282260 | Pathway To Change Counseling Services | Community/Behavioral Health | 2223 S Meridian, Puyallup, WA 98371-7503 | 2015-08-11 |
| 1073902714 | Sharon Y Young, LLC | Community/Behavioral Health | 12511 Meridian E, Suite 201, Puyallup, WA 98373-3425 | 2015-01-19 |
| 1497168371 | Puyallup Psychotherapeutic Alliance | Community/Behavioral Health | 104 W Main, 202, Puyallup, WA 98371-8904 | 2014-06-09 |
| 1952646150 | Rebecca Schiltz Therapy LLC | Community/Behavioral Health | 105 W Main Ste A, Puyallup, WA 98371-5388 | 2012-11-29 |
| Find all providers in PUYALLUP | ||||
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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.