DESERIE M FILLMORE HARDY (NPI# 1760501183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760501183 |
| Entity Type | Individual |
| Full Name | DESERIE M FILLMORE HARDY |
| Credential | MCP, CDP |
| Practice Address |
135 W Main St Chehalis WA 98532-4817 |
| Mailing Address |
519 S Iron St Centralia WA 98531-3923 |
| Practice Telephone | 3607486696 |
| Mailing Telephone | 2538827623 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CP00003653 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CHEMICAL DEPENDENCY PROFESSIONAL | CP00003653 | 01 |
| Street Address |
135 W MAIN ST |
| City | CHEHALIS |
| State | WA |
| Zip Code | 98532-4817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255943 | Crystal Dawn Wilson | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2020-05-04 |
| 1225659212 | Michael Koplin | Peer Specialist | 135 W Main St, Chehalis, WA 98532-4817 | 2020-04-30 |
| 1396375002 | Erica Renee Gavin | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2020-01-22 |
| 1639731755 | Breeann Delynn Bryson | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-06-28 |
| 1730749987 | Joseph Seung Chinn | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-06-19 |
| 1518522929 | Safiyatu Njai | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-05-01 |
| 1114581261 | Nickolas Casey Root | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-04-24 |
| 1972061653 | Jason Still | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-03-12 |
| 1285192567 | Meagan Marina Gallegos | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-03-06 |
| 1336606888 | Whitney Felkl | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140832 | Joshua Russell Wachter | Registered Nurse | 275 W. Vine St., Napavine, WA 98532 | 2020-09-28 |
| 1891339123 | Dara Casey | Technician | 271-1 Romerman Rd, Chehalis, WA 98532 | 2019-10-30 |
| 1265997704 | April D Bacongco | Counselor | 500 Se Washington St, Chehalis, WA 98532 | 2019-02-08 |
| 1235610155 | Alyssa Dawn Ware | Physical Therapist | 1441 Kresky Ave, Chehalis, WA 98532 | 2018-08-28 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1043709314 | Kevin Bumatay Duran | Family Medicine | 931 S. Market Blvd, Chehalis, WA 98532 | 2018-05-02 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1285155366 | Great Rivers Behavioral Health Organization | Community/Behavioral Health | 57 W Main Street, Suite 260, Chehalis, WA 98532 | 2017-06-29 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1841726221 | Dodi Forgione | Counselor | 2401 Ne Kresky Ave Ste D, Chehalis, WA 98532 | 2017-05-04 |
| Find all providers in zip 98532 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174095392 | Jennifer Lynn Canaan | Counselor | 505 Se Adams Ave, Chehalis, WA 98532-3031 | 2018-12-28 |
| 1457848970 | Sarah Louise Wolbert | Counselor | 151 Ne Hampe Way Ste C2-1, Chehalis, WA 98532-2403 | 2018-04-19 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1689726499 | Inner Peace Counseling, Inc | Counselor | 118 N Market Blvd, Suite 1, Chehalis, WA 98532-2666 | 2007-01-18 |
| 1174137152 | Derik L Sandoval | Counselor | 500 Se Washington Ave, Chehalis, WA 98532-3058 | 2020-09-07 |
| 1477161552 | Jason Immanuel Brandis | Counselor | 1956 Ne Kresky Ave, Chehalis, WA 98532-2307 | 2020-07-15 |
| 1871113498 | Catrena D Taylor | Counselor | 151 N Market Blvd, Chehalis, WA 98532-2677 | 2020-04-23 |
| 1912534470 | Holly Ann Neill | Counselor | 1956 Ne Kresky Ave, Chehalis, WA 98532-2307 | 2020-03-25 |
| 1942840160 | Community Integrated Health Services, LLC | Counselor | 57 W Main St, Chehalis, WA 98532-4815 | 2020-01-15 |
| Find all providers in CHEHALIS | ||||
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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.