| Beautiful Autism Llc | |
|
16710 Smokey Point Blvd Ste 402 Arlington WA 98223 | |
| (360) 363-4234 | |
| (360) 363-4235 |
| Full Name | Beautiful Autism Llc |
|---|---|
| Speciality | Counselor |
| Location | 16710 Smokey Point Blvd Ste 402, Arlington, Washington |
| Authorized Official Name and Position | Stacey Williams (OFFICE MANAGER) |
| Authorized Official Contact | 3603634234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Autism Llc 17825 59th Ave Ne Ste B Arlington WA 98223-6453 Ph: (360) 363-4234 | Beautiful Autism Llc 16710 Smokey Point Blvd Ste 402 Arlington WA 98223 Ph: (360) 363-4234 |
| NPI Number | 1841651585 |
|---|---|
| Provider Enumeration Date | 03/08/2016 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 6608282991 |
|---|---|
| Medicare Enrollment ID | O20210311001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841651585 | NPI | - | NPPES |
| Provider Name | Kazuyo Asada |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184166365 PECOS PAC ID: 3375892821 Enrollment ID: I20180816003207 |
| Provider Name | Ellen E Soukup |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558747543 PECOS PAC ID: 2961800826 Enrollment ID: I20211006002150 |
| Provider Name | Shlomit Smargon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801120290 PECOS PAC ID: 1850799719 Enrollment ID: I20211006002217 |
| Provider Name | Rayme J Rogge |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891226916 PECOS PAC ID: 4183008378 Enrollment ID: I20220907003674 |
| Provider Name | Nicole M Pulse |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841918661 PECOS PAC ID: 4486022126 Enrollment ID: I20221130001255 |
| Provider Name | Mollie M Voigt |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295431328 PECOS PAC ID: 9436508421 Enrollment ID: I20231215003138 |
| Provider Name | Jennifer W Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417245234 PECOS PAC ID: 9436565728 Enrollment ID: I20240102002217 |
| Provider Name | Ramanjot K Basanti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669992863 PECOS PAC ID: 4789034844 Enrollment ID: I20240102002327 |
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