RUSTY SHANE LISTER (NPI# 1902421506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902421506 |
| Entity Type | Individual |
| Full Name | RUSTY SHANE LISTER |
| Practice Address |
1305 Tacoma Ave S Ste 305 Tacoma WA 98402-1903 |
| Practice Telephone | 4793520128 |
| Mailing Telephone | 2533965827 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | WA | Behavioral Health & Social Service Providers |
| Street Address |
1305 TACOMA AVE S STE 305 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669566600 | Amy Lennon Riggio | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2006-10-03 |
| 1760098693 | Ione Marie Dorris | Technician/Technologist | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-09-16 |
| 1154961159 | Gloriam Zaid Mercado-justiniano | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-01-08 |
| 1215576152 | Roger Jonathan Gault | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-12-23 |
| 1932745767 | Jennifer Ann Marie Gaines | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-11-27 |
| 1891357711 | James Christian Da | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-07-01 |
| 1174183131 | Jamin A Taaffe | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-20 |
| 1760041396 | Kenneth Benjamin Leonard Landry | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-07 |
| 1790344513 | Peanina Savea Ah San Moore | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-06 |
| 1508425331 | David Andrew Lawler-brown | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445614 | Danica Thomas | Counselor | 415 S 13th St, Tacoma, WA 98402-3415 | 2020-10-19 |
| 1720696172 | Evander Suju | Counselor | 4910 N Bristol St, Tacoma, WA 98407-2124 | 2020-07-21 |
| 1033732615 | Mary Amanda Graham | Counselor | 510 S 35th St, Tacoma, WA 98418-6824 | 2020-05-18 |
| 1043831258 | Christine Marie Petersen | Counselor | 601 136th St E, Tacoma, WA 98445-1563 | 2020-04-28 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1568016731 | Gabriella Salas-trujillo | Counselor | 3109 N 7th St, Tacoma, WA 98406-6218 | 2019-07-26 |
| 1124686290 | Emmanuel Villarivera | Counselor | 612 113th St S, Tacoma, WA 98444-4902 | 2019-06-03 |
| 1588227094 | Aimee Lauren Peyton-greene | Counselor | 6621 S Wapato St, Tacoma, WA 98409-9082 | 2019-04-19 |
| 1679037535 | Sapati Siose | Counselor | 4021 S Bell St, Tacoma, WA 98418-7820 | 2019-01-24 |
| 1255849980 | Rodney D Terry | Counselor | 4509 S Union Ave Apt 3, Tacoma, WA 98409-4508 | 2018-01-16 |
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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.