GREENLAKE WELLNESS GROUP (NPI# 1396306973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396306973 |
| Entity Type | Organization |
| Organization Name | GREENLAKE WELLNESS GROUP |
| Practice Address |
7900 E Green Lake Dr N Ste 202 Seattle WA 98103-4818 |
| Practice Telephone | 2066597161 |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |
| Authorized Official Name | KATELYN DUFEK (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 2066597161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GREENLAKE WELLNESS GROUP, LLC | 7900 E Green Lake Dr N, Suite 202, Seattle, WA 98103-4818 |
| Street Address |
7900 E GREEN LAKE DR N STE 202 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98103-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558513283 | Shannon Nicole Budelman | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2008-10-13 |
| 1215554886 | Kristina Krohn | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2020-06-30 |
| 1124649397 | Julia Jenkins Counseling Services | Clinic/Center | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2020-04-29 |
| 1982246500 | Sky Circles Healing Arts Pllc | Clinic/Center | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2019-10-15 |
| 1366009177 | Sheree Michelle Price | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2019-05-28 |
| 1871008847 | Donald Clifton | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2017-12-12 |
| 1689037939 | Bethany Bylsma | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2016-04-04 |
| 1487057964 | Kirstin Zoe Nicole | Counselor | 7900 E Green Lake Dr N Ste 202, Seattle, WA 98103-4818 | 2014-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743949 | Amy Lindsey | Naturopath | 3670 Stone Way North, Seattle, WA 98103 | 2020-09-01 |
| 1073153748 | Eric Vincent Currier | Specialist | 7218 Linden Ave. N., Seattle, WA 98103 | 2020-01-10 |
| 1235770512 | Donna Dianne Campbell | Technician | 748 N 95th St #202, Seattle, WA 98103 | 2019-10-08 |
| 1841844529 | Devin Bard | Counselor | 819 N 49th St, Suite 229, Seattle, WA 98103 | 2019-07-30 |
| 1811453343 | Matkel Corporation | Massage Therapist | 4459 Fremont Ave N Ste 2, Seattle, WA 98103 | 2019-02-20 |
| 1063980381 | Dennis Gordon Grove | Counselor | 701 N 36th St, Ste 300, Seattle, WA 98103 | 2018-11-05 |
| 1962994681 | Taja Estrada | Psychologist | 7222 Linden Avenue N, Suite A, Seattle, WA 98103 | 2018-05-30 |
| 1073015129 | Kelly A Robison | Massage Therapist | 4459 Fremont Ave North, Suite 2, Seattle, WA 98103 | 2018-03-05 |
| 1609387927 | Andrew Rogers | Counselor | 1307 North 45th Street, Suite 200, Seattle, WA 98103 | 2017-10-13 |
| 1720513096 | Fedora Katz | Dentist | 2108 N Pacific Street Ap 203, Seattle, WA 98103 | 2017-04-25 |
| Find all providers in zip 98103 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920734 | Kayla Robin Daffon | Counselor | 2464 S College St Apt 1, Seattle, WA 98144-4764 | 2020-10-23 |
| 1184223463 | Mai Okano | Counselor | 929 N 130th St, Seattle, WA 98133-7500 | 2020-10-19 |
| 1952917676 | Christy Marie Saevivat | Counselor | 2641 42nd Ave Sw Apt 416, Seattle, WA 98116-4607 | 2020-09-17 |
| 1811501208 | Chelsea Gene Whipple | Counselor | 3925 Wallingford Ave N, Seattle, WA 98103-8247 | 2020-09-02 |
| 1558975235 | Miranda Plummer | Counselor | 2122 S Jackson Street, Seattle, WA 98144 | 2020-09-01 |
| 1043823974 | Jonathan G Huerta | Counselor | 9108 2nd Ave Ne, Seattle, WA 98115-2709 | 2020-08-29 |
| 1053924191 | Claire Sanchez | Counselor | 2033 6th Ave # 609, Seattle, WA 98121-2573 | 2020-08-28 |
| 1790397156 | Jaymie Rojas-luna | Counselor | 4634 E Marginal Way S # 4636, Seattle, WA 98134-2398 | 2020-08-18 |
| 1013526821 | Kimberly Kong | Counselor | 919 S King St, Seattle, WA 98104-3040 | 2020-07-28 |
| 1891303418 | Chloe Mae Caswell | Counselor | 3501 Rainier Ave S, Seattle, WA 98144-3555 | 2020-07-20 |
| Find all providers in SEATTLE | ||||
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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.