MINDSOURCE CENTER, LLC (NPI# 1477978849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477978849 |
| Entity Type | Organization |
| Organization Name | MINDSOURCE CENTER, LLC |
| Practice Address |
27023 164th Ave Se Covington WA 98042-8241 |
| Practice Telephone | 2536397146 |
| Practice Fax Number | 2536397145 |
| Mailing Telephone | 2536397146 |
| Mailing Fax Number | 2536397145 |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2014-02-21 |
| Authorized Official Name | CAROLINE SHEPPARD (DIRECTOR) |
| Authorized Official Telephone | 2533500661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 025 | WA | Agencies |
| Street Address |
27023 164TH AVE SE |
| City | COVINGTON |
| State | WA |
| Zip Code | 98042-8241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225069933 | Louise T Harris | Counselor | 27023 164th Ave Se, Covington, WA 98042-8241 | 2006-07-05 |
| 1639778590 | Carla Russell | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-10-21 |
| 1396359105 | Kelsey Brionne Bingham | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-08-31 |
| 1023634334 | Viet Quoc Pham | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-06-23 |
| 1770107781 | Joanna Rae Maggiacomo | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-06-04 |
| 1629602743 | Megan Rose Smith | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-02-27 |
| 1700417946 | Angelo Suarez Ocampo | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2020-01-27 |
| 1760028187 | Noell Jankowski | Behavioral Analyst | 27023 164th Ave Se, Covington, WA 98042-8241 | 2019-11-20 |
| 1154963155 | Hannah May Ho | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2019-10-10 |
| 1508408691 | John Timothy Daniel Altamira | Behavior Technician | 27023 164th Ave Se, Covington, WA 98042-8241 | 2019-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483239 | Baptista Kwok Dds1 Pllc | Dentist | 17265 Se Wax Rd., #101, Covington, WA 98042 | 2020-09-28 |
| 1609489640 | Hua Wang | Massage Therapist | 27641 Covington Way Se, Ste 1, Covington, WA 98042 | 2020-08-28 |
| 1417416678 | Anatoliy Voznyarskiy | Behavior Technician | 27023 164th. Ave Se, Covington, WA 98042 | 2019-03-18 |
| 1639693393 | Michele Shilley | Registered Nurse | 24519 185th Pl Se, Covington, WA 98042 | 2017-08-02 |
| 1104281526 | Kimberly Destefano | Licensed Practical Nurse | 27446 151st Pl Se, Kent, WA 98042 | 2015-12-30 |
| 1508243403 | Dora Arralde | Registered Nurse | 14620 S.e. 244th St, Kent, WA 98042 | 2015-04-29 |
| 1609299486 | Mei Ing Yau | Registered Nurse | 14311 Se 243rd St, Kent, WA 98042 | 2014-01-29 |
| 1043594658 | Karen Ann Little | Specialist | 28027 140th Lane Se, Kent, WA 98042 | 2011-09-30 |
| 1326327073 | Julie A Taylor | Occupational Therapy Assistant | 15630 Se 262nd Pl, Covington, WA 98042 | 2011-08-12 |
| 1720380397 | Blanka Karasek | Pharmacist | 17023 Se 272nd St., Safeway Pharmacy, Covington, WA 98042 | 2010-12-02 |
| Find all providers in zip 98042 | ||||
| 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] |
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|---|---|---|---|---|
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| 1730547977 | Paragon Wellness, LLC | Community/Behavioral Health | 726 E Rutland St, Covington, LA 70433-3223 | 2016-02-02 |
| 1396136933 | Tchefuncte Family Counseling | Community/Behavioral Health | 321 N Vermont St, Suite 203, Covington, LA 70433-2833 | 2015-02-17 |
| 1780087007 | Parr Educational Evaluations, LLC | Community/Behavioral Health | 5001 Hwy190, Suite B, Covington, LA 70433 | 2014-10-01 |
| 1821497603 | Around Atlanta Psychotherapy Concepts, LLC | Community/Behavioral Health | 580 Clearbrook Dr, Covington, GA 30016-9134 | 2014-08-18 |
| 1023444197 | Second Chance Youth Community Center Inc | Community/Behavioral Health | 3303 Salem Rd, Covington, GA 30016-1865 | 2013-09-20 |
| 1902249485 | Family Preservation Services, Inc. | Community/Behavioral Health | 4050 Midland Trl, Covington, VA 24426-5403 | 2013-04-15 |
| 1831532431 | Family Preservation Services, Inc. | Community/Behavioral Health | 100 Gleason Dr, Covington, VA 24426-6246 | 2013-04-12 |
| 1730522335 | Family Preservation Services, Inc. | Community/Behavioral Health | 1000 Riverview Farm Rd, Covington, VA 24426-6245 | 2013-04-12 |
| 1215294137 | Scholar Specialized Treatment Services | Community/Behavioral Health | 45 Wellstone Pl, Covington, GA 30014-7076 | 2012-04-17 |
| Find all providers in COVINGTON | ||||
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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.