THURSTON MASON BEHAVIORAL HEALTH ORGANIZATION (NPI# 1265932198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265932198 |
| Entity Type | Organization |
| Organization Name | THURSTON MASON BEHAVIORAL HEALTH ORGANIZATION |
| Other Organization Name | OLYMPIC HEALTH AND RECOVERY SERVICES |
| Practice Address |
612 Woodland Square Loop Se Ste 401 Lacey WA 98503-1070 |
| Practice Telephone | 3607635828 |
| Mailing Telephone | 3607635828 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-02-16 |
| Authorized Official Name | MARK FREEDMAN (ADMINISTRATOR) |
| Authorized Official Telephone | 3605072710 |
| Authorized Official Credential | LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 603569721 | WA | Agencies |
| Other Name | Type Code |
|---|---|
| Olympic Health and Recovery Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | THURSTON MASON BEHAVIORAL HEALTH ORGANIZATION, LLC | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 |
| Street Address |
612 WOODLAND SQUARE LOOP SE STE 401 |
| City | LACEY |
| State | WA |
| Zip Code | 98503-1070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982976197 | Adelina Georgieva Dana | Counselor | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2012-02-02 |
| 1306445820 | Seth Opp-beckman | Peer Specialist | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2020-10-26 |
| 1588262596 | Anastasia Webster | Peer Specialist | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2020-10-12 |
| 1316563364 | Athena M Ayres | Peer Specialist | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2020-06-24 |
| 1760007504 | Olympic Health and Recovery Services | Community/Behavioral Health | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2020-06-08 |
| 1063062503 | Michelle Kim Soto | Counselor | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2019-09-17 |
| 1558913145 | Molly K Mciver | Case Manager/Care Coordinator | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2019-07-12 |
| 1619535887 | Kimberly Wash | Case Manager/Care Coordinator | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2019-06-03 |
| 1376006783 | Teresa Ann Nisbet | Peer Specialist | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2019-04-11 |
| 1871050526 | Herschel Bernard Mcfarland | Peer Specialist | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2019-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457838989 | Michele Nordgren Bourque | Psychologist | 4329 Concordia Lane Se, Lacey, WA 98503 | 2018-07-26 |
| 1831638675 | Trevor John Marum | Chiropractor | 3945 8th Ave Se, Lacey, WA 98503 | 2017-02-13 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1144683616 | Millenda Thomas | Registered Nurse | 1233 Firpark Dr. S.e., Lacey, WA 98503 | 2016-04-01 |
| 1609257245 | Erika Charlotte Vonkotzebue | Counselor | 4401 37th Ave. Se #25, Lacey, WA 98503 | 2015-06-09 |
| 1437576196 | Candy Nelson | Registered Nurse | 4410 6th Ave Se, Apt# 115, Lacy, WA 98503 | 2014-03-19 |
| 1134563919 | Alvin Fitzgerald | Pharmacist | 665 Sleater Kinney Rd., S.e, Target Pharmacy #1355, Lacey, WA 98503 | 2013-04-23 |
| 1518200724 | Katherine Mary Marsh | Psychologist | 5191 Corporate Center Court Se, Lacey, WA 98503 | 2013-04-05 |
| 1740530906 | Leanna Marie Mcbroom | Massage Therapist | 1608 Diamond Loop Se, Lacey, WA 98503 | 2012-09-14 |
| 1831445196 | Joyce Emily Christensen Coniff | Counselor | 5706 39th Ave Se., Lacey, WA 98503 | 2012-07-24 |
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| 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 |
|---|---|---|---|---|
| 1497131247 | Pathways Mental Health Services | Community/Behavioral Health | 1230 Carpenter Rd Se # C-3se, Lacey, WA 98503-7219 | 2015-08-04 |
| 1013182633 | Cain, Atwell & Associates, Inc. | Community/Behavioral Health | 5709 Lacey Blvd Se, Suite 204, Lacey, WA 98503-2495 | 2008-04-24 |
| 1760007504 | Olympic Health and Recovery Services | Community/Behavioral Health | 612 Woodland Square Loop Se Ste 401, Lacey, WA 98503-1070 | 2020-06-08 |
| 1275162307 | Berring Investment Group, LLC | Community/Behavioral Health | 4313 6th Ave Se Ste C, Lacey, WA 98503-1072 | 2020-04-01 |
| 1902283831 | April Ajayya Godsey, LLC | Community/Behavioral Health | 8830 Tallon Ln Ne, Suite E, Lacey, WA 98516-6656 | 2015-04-29 |
| 1396179545 | Basics Northwest | Community/Behavioral Health | 8282 28th Ct Ne, Suite A, Lacey, WA 98516-7162 | 2013-08-23 |
| 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 |
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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.