BLUE WATER BEHAVIORAL CONSULTING LLC (NPI# 1811311517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811311517 |
| Entity Type | Organization |
| Organization Name | BLUE WATER BEHAVIORAL CONSULTING LLC |
| Practice Address |
851 Se Pioneer Way 201 Oak Harbor WA 98277 |
| Mailing Address |
1777 S. Burlington Blvd #465 Burlington WA 98233 |
| Practice Telephone | 3603335684 |
| Practice Fax Number | 3602303272 |
| Mailing Telephone | 3603335684 |
| Mailing Fax Number | 3602303272 |
| Enumeration Date | 2014-02-16 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | RACHEL DANIELLE WAGNER (CEO) |
| Authorized Official Telephone | 3603335684 |
| Authorized Official Credential | MS, LBA, BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | 1-10-7191 | Agencies | |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2041449 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1777 S Burlington Blvd Ste 465, Burlington, WA 982333223 | 3603335684 | 3602303272 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BLUE WATER BEHAVIORAL CONSULTING LLC | 851 Se Pioneer Way Ste 201, Oak Harbor, WA 98277-5789 |
| Street Address |
851 SE PIONEER WAY 201 |
| City | OAK HARBOR |
| State | WA |
| Zip Code | 98277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952951782 | Amber Dorothy Rettus | Counselor | 31640 Wa -20 #1, Oak Harbor, WA 98277 | 2019-09-13 |
| 1528612082 | Grace Alfery Finnell | Pharmacist | 31645 Sr 20, Oak Harbor, WA 98277 | 2019-08-01 |
| 1407321839 | Leah Marie Threats | Behavior Technician | Advance Behavioral Education Continuum, 231 Se Barrington Dr. Ste 201, Oak Harbor, WA 98277 | 2018-10-12 |
| 1285115329 | Jared M Wirth | Dentist | 275 Se Cabot Dr., #b201, Oak Harbor, WA 98277 | 2018-08-27 |
| 1952896854 | Makella Ann Mccormack | Behavior Technician | 231 Se Barrington Dr. Ste 203, Oak Harbor, WA 98277 | 2018-06-25 |
| 1972004703 | Sophia Kaye Johnson | Counselor | 3165 Wa-20 Suite#1, Oak Harbor, WA 98277 | 2018-02-27 |
| 1043728827 | Lance D Keyes Dds | Dentist | 32650 State Route 20 Ste E106, Oak Harbor, WA 98277 | 2018-01-16 |
| 1689195075 | Laboratory Corporation of America | Clinical Medical Laboratory | 275 Se Cabot Dr Ste A9, Oak Harbor, WA 98277 | 2017-07-06 |
| 1841723368 | Stephanie Bailey | Behavioral Analyst | 231 Barrington Dr. Suite 201, Oak Harbor, WA 98277 | 2017-04-11 |
| 1336684463 | Angel Lyn Faith Camello | Behavior Technician | 31955 State Route 20, #3, Oak Harbor, WA 98277 | 2016-12-28 |
| Find all providers in zip 98277 | ||||
| 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 |
|---|---|---|---|---|
| 1043670177 | Sunrise Services, Inc. | Community/Behavioral Health | 530 Ne Midway Blvd, Oak Harbor, WA 98277-2660 | 2016-03-02 |
| 1407143746 | Island County Recovery Services | Community/Behavioral Health | 31640 Sr 20, Suite 1, Oak Harbor, WA 98277-3128 | 2011-07-07 |
| 1710210950 | Life Without Limits, LLC | Community/Behavioral Health | 41 Ne Midway Blvd Ste 105, Oak Harbor, WA 98277-4953 | 2009-09-04 |
| 1245355973 | Island Assessment and Counseling Center, Inc. | Community/Behavioral Health | 520 E Whidbey Ave Ste 205, Oak Harbor, WA 98277-5921 | 2007-03-20 |
| 1932651056 | New Path LLC | Community/Behavioral Health | 640 E Whidbey Ave, Oak Harbor, WA 98277-5901 | 2016-10-25 |
| 1881910057 | Co-pilot Counseling | Community/Behavioral Health | 164 W Water St, Oak Harbor, OH 43449-1332 | 2010-04-13 |
| 1942468400 | Karen A Miller, Licsw, Pllc | Community/Behavioral Health | 275 Se Cabot Dr, Suite B206, Oak Harbor, WA 98277-3715 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821539 | Cpf Breakthrough, LLC | Community/Behavioral Health | 11711 E Sprague Ave Ste D4, Spokane Valley, WA 99206-6122 | 2020-11-03 |
| 1538760111 | Nw Family Recovery Solutions | Community/Behavioral Health | 710 Bay St, Port Orchard, WA 98366-5310 | 2020-11-02 |
| 1891395091 | Art Nelson LLC | Community/Behavioral Health | 18679 15th Loop Ne, Poulsbo, WA 98370-7436 | 2020-10-27 |
| 1508463803 | Kim Lampson Pllc | Community/Behavioral Health | 9725 Se 36th St Ste 301, Mercer Island, WA 98040-3840 | 2020-10-08 |
| 1518573971 | Olive Crest | Community/Behavioral Health | 10125 Frontier Pl Nw, Silverdale, WA 98383-9408 | 2020-09-21 |
| 1659980563 | Deborah M Connors Pllc | Community/Behavioral Health | 534 Ne Everett St Ste 201, Camas, WA 98607-2025 | 2020-07-27 |
| 1790393221 | Charmd Behavioral & Health LLC | Community/Behavioral Health | 4318 233rd Pl Se, Bothell, WA 98021-9057 | 2020-07-21 |
| 1699392548 | Ryan Wathne Pllc | Community/Behavioral Health | 2711 E Madison St Ste 203, Seattle, WA 98112-4763 | 2020-06-26 |
| 1184241192 | Optimum Counseling, LLC | Community/Behavioral Health | 10710 Ne 10th St Apt 108, Bellevue, WA 98004-1033 | 2020-06-25 |
| 1467079467 | Recovery Cafe of Clark County | Community/Behavioral Health | 3312 E Fourth Plain Blvd Ste 100, Vancouver, WA 98661-5489 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
| City | OAK HARBOR |
| Zip Code | 98277 |
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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.