CASCADE COMMUNITY HEALTHCARE NPI 1619068624

NPI Information

NPI: 1619068624
Provider Name: CASCADE COMMUNITY HEALTHCARE

Doing Business As: CASCADE MENTAL HEALTH CARE

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 50D2090749

Address:
2428 W REYNOLDS AVE
CENTRALIA, WA
ZIP 98531
Phone: (360) 330-9044
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CASCADE COMMUNITY HEALTHCARE is a mental health counselor in Centralia, WA. CASCADE COMMUNITY HEALTHCARE NPI is 1619068624. The provider is registered as an organization entity type.
The provider Is Doing Business As Cascade Mental Health Care.

The provider's business location address is:

2428 W REYNOLDS AVE
CENTRALIA, WA
ZIP 98531
Phone: (360) 330-9044

The provider's authorized official is Jonique Dietzen .
The authorized official title is Finance Manager and has the following contact phone number (360) 345-6566.

The CLIA number assigned to this NPI record is 50D2090749 - other - community mental health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 3/31/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7035090	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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