BELLEVUE CLINIC FOR BEHAVIORAL HEALTH (NPI# 1124481783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124481783 |
| Entity Type | Organization |
| Organization Name | BELLEVUE CLINIC FOR BEHAVIORAL HEALTH |
| Practice Address |
2105 112th Ave Ne Suite 201 Bellevue WA 98004-2945 |
| Practice Telephone | 2533472665 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |
| Authorized Official Name | DR. OSAMA BANKESLY (PRESIDENT) |
| Authorized Official Telephone | 2064038814 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
MD00045130 | WA | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BELLEVUE CLINIC FOR BEHAVIORAL HEALTH PLLC | 2105 112th Ave Ne #201, Bellevue, WA 98004 |
| Street Address |
2105 112TH AVE NE SUITE 201 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730295882 | Rebecca Lynn Baudino | Counselor | 2105 112th Ave Ne, Suite 200, Bellevue, WA 98004 | 2006-08-22 |
| 1124533666 | Nadia Eleza Mahmud | Dietitian, Registered | 2105 112th Ave Ne, Bellevue, WA 98004-2945 | 2017-12-06 |
| 1679021117 | Lida Johnson Buckley | Dietitian, Registered | 2105 112th Ave Ne, Suite 101, Bellevue, WA 98004-2945 | 2016-09-13 |
| 1538484274 | Sivie Suckerman | Counselor | 2105 112th Ave Ne, Suite 200, Bellevue, WA 98004-2945 | 2010-04-06 |
| 1508192766 | Daniela Costea | Psychologist | 2105 112th Ave Ne, Suite 101, Bellevue, WA 98004 | 2009-10-22 |
| 1093971491 | David Dixon | Psychologist | 2105 112th Ave Ne, #200, Bellevue, WA 98004-2945 | 2008-08-05 |
| 1265610281 | Scott E. Tyler Md Ps | Family Medicine | 2105 112th Ave Ne, Bellevue, WA 98004-2945 | 2008-01-31 |
| 1841486230 | Renee Shechtman Sanford | Social Worker | 2105 112th Ave Ne, Suite 200, Bellevue, WA 98004-2945 | 2007-09-19 |
| 1659574093 | Steve Anderson | Counselor | 2105 112th Ave Ne, Bellevue Office Park Suite 200, Bellevue, WA 98004-2945 | 2007-06-05 |
| 1386854305 | Stephen W. Best | Marriage & Family Therapist | 2105 112th Ave Ne, Suite 200, Bellevue, WA 98004-2945 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497938807 | John Michael Reardon | Psychologist | 2501 Capehart Rd, Bellevue, NE 68123 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720511256 | J. Dale Howard, M.d. | Psychologist | 1919 N Pearl St Ste C3, Tacoma, WA 98406-2490 | 2017-04-11 |
| 1528257433 | S L Clark Md Inc Ps | Psychologist | 9515 60th Ave W, Mukilteo, WA 98275 | 2007-10-16 |
| 1770706046 | Diane L Jamieson | Psychologist | 543 Main St, Ste 104, Edmonds, WA 98020-3162 | 2007-04-11 |
| 1568584571 | James Alan Knutson | Psychologist | 830 6th St S, Kirkland, WA 98033-6714 | 2007-04-03 |
Please comment or provide details below to improve the information on BELLEVUE CLINIC FOR BEHAVIORAL HEALTH.
| 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.