SQUAREONE SERVICES (NPI# 1730654849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730654849 |
| Entity Type | Organization |
| Organization Name | SQUAREONE SERVICES |
| Other Organization Name | SQUAREONE |
| Practice Address |
21300 68th Ave W Ste 105 Lynnwood WA 98036-7310 |
| Practice Telephone | 4254123155 |
| Practice Fax Number | 4252493522 |
| Mailing Telephone | 2068223380 |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2019-05-06 |
| Authorized Official Name | JESSICA WHITEHEAD (CEO) |
| Authorized Official Telephone | 2068223380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SquareOne | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 21300 68th Ave W, Lynnwood, WA 98036 | 2068223380 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SQUAREONE SERVICES, SPC | 21300 68th Ave W Ste 105, Lynnwood, WA 98036-7310 |
| Washington State Corporations | SQUAREONE SERVICES, SPC | 21300 68th Ave W, Ste 105, Lynnwood, WA 98036-7310 |
| Street Address |
21300 68TH AVE W STE 105 |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972156636 | Amy Hofeditz | Counselor | 21300 68th Ave W Ste 105, Lynnwood, WA 98036-7310 | 2019-07-22 |
| 1689142960 | Elizabeth Boudreaux | Counselor | 21300 68th Ave W Ste 105, Lynnwood, WA 98036-7310 | 2018-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145682 | Sea Mar Community Health Centers | Clinic/Center | 4100 194th St Sw Ste 120, Lynnwood, WA 98036-4613 | 2020-08-18 |
| 1821382870 | Asian American Chemical Dependency Treatment Services | Clinic/Center | 5116 196th St Sw Ste 101, Lynnwood, WA 98036-6148 | 2011-06-07 |
| 1689705022 | Evergreen Manor Opt Lynwood | Clinic/Center | 3810 196th St Sw, 11, Lynnwood, WA 98036 | 2007-03-08 |
| 1598948093 | Sea-mar Community Health Center | Clinic/Center | 19707 44th Ave W, Suite 101, Lynnwood, WA 98036-6757 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386278372 | Social Treatment Opportunity Programs II, Inc | Clinic/Center | 600 S 1st Ave, Othello, WA 99344-1703 | 2020-02-27 |
| 1326672692 | Excelsior Integrated Care Center LLC | Clinic/Center | 3910 W. Indian Trail Rd, Spokane, WA 99208-4739 | 2020-02-26 |
| 1659919561 | Baart Behavioral Health Services, Inc. | Clinic/Center | 716 S Chase St, Port Angeles, WA 98362-6122 | 2019-12-11 |
| 1346888260 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1520 Ne Riddell Rd Ste 110, Bremerton, WA 98310-3005 | 2019-12-11 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
| 1013444181 | Freedom Recovery, LLC | Clinic/Center | 715 E Yelm Ave Ste 6, Yelm, WA 98597-8714 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
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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.