LYRIC G SISTERHEN (NPI# 1104468362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104468362 |
| Entity Type | Individual |
| Full Name | LYRIC G SISTERHEN |
| Practice Address |
7823 Box Elder Dr Sw Olympia WA 98512-2326 |
| Mailing Address |
307 W Cota St Shelton WA 98584-2265 |
| Practice Telephone | 3603629513 |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
7823 BOX ELDER DR SW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98512-2326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161402 | Yavonnie Leslie Griggs | Peer Specialist | 3285 Ferguson Ln Sw, Tumwater, Wa 98512, Tumwater, WA 98512 | 2020-10-13 |
| 1205465622 | Falina Marie Luce | Counselor | 3285 Ferguson St, Olympia, WA 98512 | 2020-04-07 |
| 1881234912 | Andres Enrique Velazquez | Counselor | 3285 Ferguson St Sw Wa 98512, Tumwater, WA 98512 | 2020-01-07 |
| 1700432507 | Maria E Zavala Negrete | Behavior Technician | 3285 Ferguson Street Southwest, Tumwater, WA 98512 | 2019-08-16 |
| 1669026951 | Bradley Allen Labrador | Social Worker | 3285 Ferguson St, Sw, Tumwater, WA 98512 | 2019-07-25 |
| 1033762893 | Janice Lapreal Swanzey | Licensed Practical Nurse | 3285 Ferguson Lane St Sw, Olympia, WA 98512 | 2019-07-22 |
| 1821569195 | Linda Marie Moffitt | Registered Nurse | 7741 Littlerock Rd. Sw, Tumwater, WA 98512 | 2018-12-16 |
| 1427534577 | Matthew Hart | Occupational Therapist | 2620 Rw Johnson Boulevard Southwest Suite 112, Tumwater, WA 98512 | 2018-07-12 |
| 1558858019 | Amy Louise Cline | Counselor | 6005 Tyee Drive Sw, Tumwater, WA 98512 | 2018-04-19 |
| 1669998183 | Bradley Ross Bishop | Registered Nurse | 3285 Ferguson Street Sw, Tumwater, WA 98512 | 2017-08-16 |
| Find all providers in zip 98512 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952881161 | Paige Gautreaux | Peer Specialist | 908 5th Avenue Se, Olympia, WA 98501 | 2018-08-16 |
| 1629682893 | Charli Warren | Peer Specialist | 1202 Black Lake Blvd Sw Ste B, Olympia, WA 98502-7208 | 2020-09-03 |
| 1184271918 | James Morris | Peer Specialist | 1000 Cherry St Se, Olympia, WA 98501-1433 | 2019-08-26 |
| 1881248169 | Carol Varble | Peer Specialist | 1000 Cherry St Se, Olympia, WA 98501-1433 | 2019-07-25 |
| 1255985537 | David Michael Richardson | Peer Specialist | 1000 Cherry St Se, Olympia, WA 98501-1433 | 2019-07-25 |
| 1609420033 | Terry Curtis Graham | Peer Specialist | 1000 Cherry St Se, Olympia, WA 98501-1433 | 2019-07-24 |
| 1114571551 | Heather Sturdevant | Peer Specialist | 1000 Cherry St Se, Olympia, WA 98501-1433 | 2019-07-24 |
| 1992364137 | Carrie Lee Moisey | Peer Specialist | 1011 10th Ave Se, Olympia, WA 98501-1566 | 2019-06-11 |
| 1982161824 | Cassandra Cleo Rhoades | Peer Specialist | 1011 10th Ave Se, Olympia, WA 98501-1566 | 2019-02-27 |
| 1790258283 | Lawrence Arnold Taylor | Peer Specialist | 1011 10th Ave Se, Olympia, WA 98501-1566 | 2019-01-07 |
| Find all providers in OLYMPIA | ||||
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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.