GREATER LAKES (NPI# 1972897320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972897320 |
| Entity Type | Organization |
| Organization Name | GREATER LAKES |
| Practice Address |
9330 59th Ave Sw Lakewood WA 98499-2858 |
| Mailing Address |
9330 59th Ave Sw Tacoma WA 98499-2858 |
| Practice Telephone | 2536205015 |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |
| Authorized Official Name | MR. BRIAN L NICHOLSON (RN) |
| Authorized Official Telephone | 2536205015 |
| Authorized Official Credential | BSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GREATER LAKES MENTAL HEALTHCARE | 9330 59th Ave Sw, Lakewood, WA 98499-2858 |
| Street Address |
9330 59TH AVE SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225039811 | Greater Lakes Mental Health Foundation Inc | Community/Behavioral Health | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2005-08-03 |
| 1568063915 | Taibika O Lofton | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-11-03 |
| 1164023552 | Meaghan Nicole Trezza | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-11-03 |
| 1295335362 | Estrella Nicole Alderete | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-10-28 |
| 1760081004 | Taylor Shae Brenneise | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-10-19 |
| 1508463324 | Lacey Lynn Gomez | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-10-05 |
| 1487261186 | Mallory Enola O'brien | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-09-26 |
| 1912513136 | Ashley Maeve Marrow | Peer Specialist | 9330 59th Ave Sw, Lakewood, WA 98499-6600 | 2020-09-22 |
| 1376158527 | Sydney Freutel | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-09-14 |
| 1063027522 | Tiffany Lynn Myers | Counselor | 9330 59th Ave Sw, Lakewood, WA 98499-2858 | 2020-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Find all providers in zip 98499 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245695022 | Caitlin Kozicki LLC | Clinic/Center | 7220 W Jefferson Ave Ste 218, Lakewood, CO 80235-2058 | 2015-12-22 |
| 1700157583 | Julie Rudiger, Lcsw, Inc. | Clinic/Center | 445 Union Blvd, Suite 203, Lakewood, CO 80228-1237 | 2012-01-25 |
| 1902129620 | Susan Coolbaugh, Inc | Clinic/Center | 6212 75th St W, Lakewood, WA 98499-8368 | 2010-03-09 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568060085 | Vanessa Honn, Phd, Ps | Clinic/Center | 3819 N Madison St, Tacoma, WA 98407-5725 | 2020-10-16 |
| 1467067439 | New Advanced Healthcare Consulting Pllc | Clinic/Center | 300 Lenora St # 984, Seattle, WA 98121-2411 | 2020-09-15 |
| 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 |
| 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.