CANYON LAKES FAMILY COUNSELING CENTER (NPI# 1871929869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871929869 |
| Entity Type | Organization |
| Organization Name | CANYON LAKES FAMILY COUNSELING CENTER |
| Other Organization Name | FOREVER HOMES COUNSELING |
| Practice Address |
3616 W 27th Ave Kennewick WA 99337-2415 |
| Practice Telephone | 5095910462 |
| Mailing Telephone | 5095910462 |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2013-09-23 |
| Authorized Official Name | MR. LYNN OWENS (OWNER) |
| Authorized Official Telephone | 5095910462 |
| Authorized Official Credential | LMHCA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | MG60390821 | WA | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MC60401601 | WA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Forever Homes Counseling | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CANYON LAKES FAMILY COUNSELING CENTER, PLLC | 3801 S Zintel Way, Ste 120, Kennewick, WA 99337-5097 |
| Street Address |
3616 W 27TH AVE |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99337-2415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366871568 | Ryan Bradley | Marriage & Family Therapist | 3616 W 27th Ave, Kennewick, WA 99337-2415 | 2013-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982238044 | Sendy D Garibay-flores | Specialist/Technologist | 1609 South Garfield St, Kennewick, WA 99337 | 2020-02-27 |
| 1407386535 | Robin Roderick | Dental Hygienist | 2510 W. 35th Ave, Kennewick, WA 99337 | 2017-06-12 |
| 1134580897 | Pamela Taylor | Counselor | 241907 E State Route 397, Kennewick, WA 99337 | 2016-03-09 |
| 1093119232 | Angela Combs | Nurse Practitioner | 3801 Zintel Way, Suite 120, Kennewick, WA 99337 | 2014-10-17 |
| 1699103036 | Zachary Daniel Mcnair | Physician Assistant | 4008 W 27th Ave, Suite 103, Kennewick, WA 99337 | 2013-10-22 |
| 1326302647 | Yvonne Teresa Sands | Nurse Practitioner | 4008 W 27th Ave Ste 103, Kennewick, WA 99337 | 2012-07-02 |
| 1144403064 | Anja Rasmussen | Physical Therapist | 3101 S. Gum St, Kennewick, WA 99337 | 2007-12-13 |
| 1558585182 | Cynthia Renee Wright | Counselor | 3801 S Zintel Way Ste 120, Kennewick, WA 99337 | 2007-04-13 |
| 1477635159 | Steven R Zirker | Physician Assistant | 4008 W 27th Ave, Suite 103, Kennewick, WA 99337 | 2006-10-20 |
| 1770699886 | Jeanie Edwards | Specialist | 228705 Game Farm Rd, Kennewick, WA 99337 | 2006-08-22 |
| Find all providers in zip 99337 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193304 | Yesica Rosas | Counselor | 8927 W Tucannon Ave Ste 107, Kennewick, WA 99336-7176 | 2020-04-22 |
| 1669019899 | Lydia Nicole Bowerly | Counselor | 8905 W Gage Blvd Ste 208, Kennewick, WA 99336-7191 | 2019-12-06 |
| 1023662590 | Shane Arthur Gulley | Counselor | 500 N. Morain St Suite 1250, Kennewick, WA 99336 | 2019-08-01 |
| 1487148680 | Tri-cities Regenerative Institute | Counselor | 8905 W Gage Blvd Ste 100, Kennewick, WA 99336-7191 | 2018-06-20 |
| 1124531488 | Ashleigh Mae Zoerb | Counselor | 4906 W 4th Ave, Kennewick, WA 99336-4168 | 2017-11-08 |
| 1881121267 | Valerie F Kirk | Counselor | 3801 S Zintel Way Ste A120, Kennewick, WA 99337-5097 | 2017-05-17 |
| 1750820122 | Luis Madrigal | Counselor | 2628 W Bruneau Pl Ste 110, Kennewick, WA 99336-3134 | 2017-02-18 |
| 1912444308 | Cassandra Mendez | Counselor | 2112 S Rainier St Apt 130, Kennewick, WA 99337-3635 | 2017-01-24 |
| 1871037994 | Timothy Mc Kee Dolph | Counselor | 500 N. Morain St. Ste. 1250, Kennewick, WA 99336 | 2016-12-08 |
| 1902254139 | Robert Bishop | Counselor | 1203 W 21st Ave, Kennewick, WA 99337-4216 | 2016-05-27 |
| Find all providers in KENNEWICK | ||||
Please comment or provide details below to improve the information on CANYON LAKES FAMILY COUNSELING CENTER.
| 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.