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HOLLY RIDGE CENTER NPI 1861549206


NPI Information

NPI: 1861549206
Provider Name: HOLLY RIDGE CENTER
Classification: Psychologist - 103TC2200X
Entity Type: Organization

Specialization: Clinical Child & Adolescent

Address:
5112 NW TAYLOR RD
BREMERTON, WA
ZIP 98312
Phone: (360) 373-2536
Get Directions

HOLLY RIDGE CENTER is a clinical child and adolescent psychologist in Bremerton, WA. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. HOLLY RIDGE CENTER NPI is 1861549206. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5112 NW TAYLOR RD
BREMERTON, WA
ZIP 98312-837
Phone: (360) 373-2536
Fax: (360) 373-4934

The provider's authorized official is Roxanne Bryson .
The authorized official title is Executive Director and has the following contact phone number (360) 373-2536.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 8/22/2020.


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
1103TC2200XPsychologistClinical Child & AdolescentYes
2104100000XSocial WorkerX
32080P0006XPediatricsDevelopmental - Behavioral PediatricsX
4235Z00000XSpeech-Language PathologistX
5364S00000XClinical Nurse SpecialistX
62251P0200XPhysical TherapistPediatricsX
7225XP0200XOccupational TherapistPediatricsX

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
17007271MEDICAIDWASHINGTON
27017742MEDICAIDWASHINGTON
37660228MEDICAIDWASHINGTON

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

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