GLORIA LYNN YOUNGBLOOD (NPI# 1922518182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922518182 |
| Entity Type | Individual |
| Full Name | GLORIA LYNN YOUNGBLOOD |
| Credential | CDPT |
| Practice Address |
1305 Tacoma Ave S Ste 305 Tacoma WA 98402-1903 |
| Mailing Address |
13222 12th Ave S Burien WA 98168-2807 |
| Practice Telephone | 2533965800 |
| Mailing Telephone | 2067697295 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-04-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CO60559177 | WA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1116 Summit Ave, Seattle, WA 981012831 | 2063230930 |
| 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 |
| 1902421506 | Rusty Shane Lister | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-06-10 |
| 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 |
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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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868276 | Mind Over Matters, Pllc | Counselor | 2525 55th Ave Ne, Tacoma, WA 98422-3404 | 2020-10-14 |
| 1376140541 | Debra Tone | Counselor | 1219 Earnest Brazill St, Tacoma, WA 98405-4025 | 2020-10-01 |
| 1881201028 | Dallas Renae Neighbors | Counselor | 711 S 25th St Ste B, Tacoma, WA 98405-4306 | 2020-09-30 |
| 1306310925 | Nancy Rubi Rosas Rodriguez | Counselor | 5915 Orchard St W., Tacoma, WA 98467 | 2019-01-16 |
| 1740751668 | Jay Yourglich | Counselor | 3315 S 23rd St Ste 102, Tacoma, WA 98405-1615 | 2018-12-17 |
| 1407327927 | Lewis A Wilson | Counselor | 721 Fawcett Ave Ste 201, Tacoma, WA 98402-5502 | 2018-12-10 |
| 1386113207 | Patricia A Neagle | Counselor | 2316 S State St Ste B, Tacoma, WA 98405-2813 | 2018-11-20 |
| 1457829343 | Ron Rn Wilkins | Counselor | 721 Fawcett Ave Ste 102, Tacoma, WA 98402-5502 | 2018-11-08 |
| 1275001620 | Matthew Mixon | Counselor | 15318 14th Avenue Ct E, Tacoma, WA 98445-2496 | 2018-11-04 |
| 1124593017 | Elisa Marie Matthews | Counselor | 5315 S Orchard St, Tacoma, WA 98467-3686 | 2018-10-08 |
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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.