SECOND FRUIT WELLNESS SERVICES LLC (NPI# 1326663311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326663311 |
| Entity Type | Organization |
| Organization Name | SECOND FRUIT WELLNESS SERVICES LLC |
| Practice Address |
2800 E Evergreen Blvd Ste B Vancouver WA 98661-4934 |
| Practice Telephone | 5038935931 |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |
| Authorized Official Name | TIFFANY AISHA EDWARDS (OWNER) |
| Authorized Official Telephone | 5038935931 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SECOND FRUIT WELLNESS SERVICES LLC | 202 E Mcloughlin Blvd # 201, Vancouver, WA 98663-3369 |
| Street Address |
2800 E EVERGREEN BLVD STE B |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98661-4934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228417 | Cynthia Ann Holt | Social Worker | 4608 Ne 47 Street, Vancouver, WA 98661 | 2020-06-01 |
| 1235793027 | James Dostert | Counselor | 1601 E 4th Blvd. Bldg. 17, Ste A212, Vancouver, WA 98661 | 2019-04-26 |
| 1306305289 | Kathryn Susanne Scott | Social Worker | Attn: Kathryn Scott, V3cnh, 1601 E. Fourth Plain Blvd., Vancouver, WA 98661 | 2019-03-19 |
| 1952860637 | Alice Rogers | Occupational Therapist | Vancouver Public Schools, 2901 Falk Rd., Vancouver, WA 98661 | 2019-03-13 |
| 1053878538 | Paula Moore | Counselor | 9626 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2019-02-21 |
| 1558825729 | Cassandra Marie Nichols | Counselor | 1601 E 4th Blvd, Vancouver, WA 98661 | 2019-01-22 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
| 1023505229 | Ellen Barbour | Counselor | 1601 E 4th Plain Blvd Bldg. 17, Ste A212, Vancouver, WA 98661 | 2018-04-13 |
| 1679096325 | Brian Scott Coleman | Counselor | 1601 East Fourth Plain Blvd., Bldg #17, Ste. A212, Vancouver, WA 98661 | 2017-07-24 |
| Find all providers in zip 98661 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058145 | Brooke Ann Enriquez | Counselor | 3606 Main St Ste 202, Vancouver, WA 98663-2235 | 2020-03-21 |
| 1053878538 | Paula Moore | Counselor | 9626 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2019-02-21 |
| 1962966127 | Anne Towler Counseling PC | Counselor | 1353 Officers Row, Vancouver, WA 98661-3856 | 2019-01-22 |
| 1386197028 | Kendall Jones | Counselor | 15105 Ne 74th St, Vancouver, WA 98682-5148 | 2016-07-29 |
| 1447610464 | Kelby Inmon | Counselor | 1104 Main St Ste 320, Vancouver, WA 98660-2955 | 2016-03-03 |
| 1164814778 | Margaret Trenholm | Counselor | 10512 Ne 37th Ave, Vancouver, WA 98686-4384 | 2015-02-19 |
| 1619379898 | Pivot Pointe Counseling Center | Counselor | 11818 Se Mill Plain Blvd. Suite 213, Vancouver, WA 98684-5091 | 2014-09-19 |
| 1922333962 | Elvira Bayless | Counselor | 2710 E Mcloughlin Blvd, Vancouver, WA 98661-4722 | 2009-10-08 |
| 1205951779 | Charles James Verro | Counselor | 314 W 15th St Ste 200, Vancouver, WA 98660-2927 | 2007-03-20 |
| 1023146628 | Arabeth Muller Mashek | Counselor | 415 W 11th St, Vancouver, WA 98660-3147 | 2007-03-02 |
| Find all providers in VANCOUVER | ||||
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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.