MR. KENNETH R ROUGHTON (NPI# 1124178090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124178090 |
| Entity Type | Individual |
| Full Name | MR. KENNETH R ROUGHTON |
| Credential | PHD |
| Practice Address |
221 E Washington Ave Dayton WA 99328-1317 |
| Mailing Address |
511 E Race St Dayton WA 99328-1646 |
| Practice Telephone | 5093821164 |
| Practice Fax Number | 5093821166 |
| Mailing Telephone | 5093821383 |
| Mailing Fax Number | 5093821166 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY00002083 | WA | Behavioral Health & Social Service Providers |
| Street Address |
221 E WASHINGTON AVE |
| City | DAYTON |
| State | WA |
| Zip Code | 99328-1317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922040526 | Blue Mountain Counseling of Columbia County | Clinic/Center | 221 E Washington Ave, Dayton, WA 99328-1317 | 2006-06-11 |
| 1740808369 | Rylie Dixon | Counselor | 221 E Washington Ave, Dayton, WA 99328-1317 | 2020-07-09 |
| 1255961447 | Michelle Fulbright | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2020-01-16 |
| 1164088464 | Teresa Rae | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2019-05-13 |
| 1285100305 | Margaret Gutierrez | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-10-16 |
| 1104306521 | Beverly June Startin | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-08-15 |
| 1699255000 | Jennifer Megan Price | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-08-15 |
| 1306324371 | Melinda Guthrie | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-08-01 |
| 1265910236 | Dimita Warren | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-08-01 |
| 1073091047 | Racheal Fletcher | Case Manager/Care Coordinator | 221 E Washington Ave, Dayton, WA 99328-1317 | 2018-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487736153 | County of Columbia | Public Health or Welfare | 1002 S 3rd Street, Ste 2, Dayton, WA 99328 | 2006-10-20 |
| 1134128911 | Columbia County Hospital District | Clinic/Center | 1012 South Third Street, Dayton, WA 99328 | 2005-07-14 |
| 1619454030 | Tasha L Willoughby | Counselor | 1012 South Third Street, Dayton, WA 99328 | 2018-07-27 |
| 1821500299 | Bruce Wayne Pollard | Social Worker | 1012 South Third Street, Dayton, WA 99328 | 2017-10-25 |
| 1811307382 | Kimberly Greene | Speech-Language Pathologist | 1012 South Third Street, Dayton, WA 99328 | 2014-05-05 |
| 1689841892 | Rebekah R Gustin | Occupational Therapist | 1012 South Third Street, Dayton, WA 99328 | 2008-05-15 |
| 1932286077 | Columbia County Hospital District | Medicare Defined Swing Bed Unit | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1518044551 | Columbia County Hospital District | Clinic/Center | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1659458610 | Columbia County Hospital District | Skilled Nursing Facility | 1012 South Third Street, Dayton, WA 99328 | 2006-11-01 |
| 1023193828 | Kim Irene Emery | Physician Assistant | 1012 South Third Street, Dayton, WA 99328 | 2006-10-27 |
| Find all providers in zip 99328 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691074 | Rita A. Carlson, Psy.d., Pllc | Psychologist | 191 Shady Grove Ln, Dayton, NV 89403-6364 | 2020-08-26 |
| 1023673100 | Katren Elizabeth Clark | Psychologist | 70 Birch Alley, Suite 240, Dayton, OH 45440 | 2019-05-05 |
| 1629379920 | Allison L Fernander | Psychologist | 9 North Edwin C Moses Blvd, Dayton, OH 45402-8470 | 2010-11-03 |
| 1548490667 | Rahema C Rodgers | Psychologist | 5045 N Main St Ste 223, Dayton, OH 45415-3637 | 2009-07-23 |
| 1710151295 | Cynthia Burton Levy | Psychologist | 17 Irongate Park Dr, Dayton, OH 45459-4616 | 2008-04-16 |
| 1033308119 | Alice L Claggett | Psychologist | 1159 Lyons Rd, Building E, Dayton, OH 45458-1857 | 2007-10-15 |
| 1740483031 | Roger G Schmidt | Psychologist | 88th Medical Group/mdos, 4881 Sugar Maple Dr., Dayton, OH 45433-5529 | 2007-06-06 |
| 1982826590 | Kathleen Ann Malloy | Psychologist | Ellis Institute, 9 N. Edwin C. Moses Blvd., Dayton, OH 45402 | 2007-05-03 |
| 1669692281 | James R. P. Fraser | Psychologist | 6550 Garber Rd, Dayton, OH 45415-2000 | 2007-04-26 |
| 1467675637 | David Nathan Zahm | Psychologist | 13612 Voland Ct, Dayton, MD 21036-1102 | 2007-04-10 |
| Find all providers in DAYTON | ||||
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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.