SUSAN COOLBAUGH, INC (NPI# 1902129620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902129620 |
| Entity Type | Organization |
| Organization Name | SUSAN COOLBAUGH, INC |
| Practice Address |
6212 75th St W Lakewood WA 98499-8368 |
| Practice Telephone | 2539838507 |
| Practice Fax Number | 2539838576 |
| Mailing Telephone | 2539838507 |
| Mailing Fax Number | 2539838576 |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |
| Authorized Official Name | MS. SUSAN FRANCES COOLBAUGH (PRESIDENT) |
| Authorized Official Telephone | 2539838507 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
AP30004202 | WA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SUSAN COOLBAUGH, INC. | 6212 75th St W, Lakewood, WA 98499 |
| Street Address |
6212 75TH ST W |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-8368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033118344 | Erin Alane Jacobson | Nurse Practitioner | 6212 75th St W, Lakewood, WA 98499-8368 | 2005-07-19 |
| 1942777453 | Sammy Gathiru Arnp | Nurse Practitioner | 6212 75th St W, Lakewood, WA 98499-8368 | 2018-11-01 |
| 1609368737 | Sammy Gathiru | Nurse Practitioner | 6212 75th St W, Lakewood, WA 98499-8368 | 2018-06-04 |
| 1295180669 | Holly Minnick-bishop Arnp, LLC | Community/Behavioral Health | 6212 75th St W, Lakewood, WA 98499-8368 | 2016-05-04 |
| 1790157923 | Holly R Minnick-bishop | Nurse Practitioner | 6212 75th St W, Lakewood, WA 98499-8368 | 2015-10-27 |
| 1952789299 | Jennifer Lynn Warwick | Social Worker | 6212 75th St W, Lakewood, WA 98499 | 2015-05-07 |
| 1821411604 | Erin Jacobson-kasler, LLC | Clinic/Center | 6212 75th St W, Lakewood, WA 98499-8368 | 2014-01-29 |
| 1619300175 | Kathryn Ann Cregan | Social Worker | 6212 75th St W, Lakewood, WA 98499-8368 | 2013-08-19 |
| 1013232990 | Jeffrey W. Thurston Arnp, Inc. | Nurse Practitioner | 6212 75th St W, Lakewood, WA 98499-8368 | 2010-04-02 |
| 1962666859 | Geraldine Ann Magee-salem | Counselor | 6212 75th St W, Lakewood, WA 98499-8368 | 2008-07-10 |
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|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1972897320 | Greater Lakes | Clinic/Center | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2011-06-02 |
| 1578896387 | Melvin Painter, Ph.d., Inc. | Clinic/Center | 14701 Detroit Ave, Suite 258, Lakewood, OH 44107-4115 | 2009-09-10 |
| 1598999666 | Preferred Behavioral Health of Nj | Clinic/Center | 725 Airport Rd, Lakewood, NJ 08701-5968 | 2009-05-05 |
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| 1194336453 | Affiliated Mental Health Programs, Inc. | Clinic/Center | 6511 51st Ave S, Seattle, WA 98118-3319 | 2020-08-11 |
| 1801406624 | Skylark Behavioral Health, Pllc | Clinic/Center | 300 Lenora St # 957, Seattle, WA 98121-2411 | 2020-08-06 |
| 1629686498 | Wendy Becker Psychotherapy | Clinic/Center | 12685 Sapphire Lane South East, Olalla, WA 98359 | 2020-07-17 |
| 1154969384 | Freedom Services, Pllc | Clinic/Center | 17775 Se Mill Plain Blvd Apt 252, Vancouver, WA 98683-7559 | 2019-12-18 |
| 1265077846 | Buena Vida Counseling Pllc | Clinic/Center | 221 W Railroad Ave Ste 2, Shelton, WA 98584-3507 | 2019-11-07 |
| 1720620644 | Ballard Avenue Psychiatry Pllc | Clinic/Center | 5306 Ballard Ave Nw Ste 317, Seattle, WA 98107-4366 | 2019-10-11 |
| 1225687544 | Lillie Mccatty, Lmhc | Clinic/Center | 203 4th Ave E Ste 307, Olympia, WA 98501-1188 | 2019-09-09 |
| 1306401278 | Christeen Deneui | Clinic/Center | 9518 49th Ave W Apt 15e, Mukilteo, WA 98275-3763 | 2019-05-07 |
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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.