Cascade Mental Health Care | |
2428 W Reynolds Ave Centralia WA 98531 | |
(360) 330-9044 | |
Not Available |
Full Name | Cascade Mental Health Care |
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Speciality | Community/Behavioral Health |
Location | 2428 W Reynolds Ave, Centralia, Washington |
Authorized Official Name and Position | Pamela Trumble (CREDENTIALING) |
Authorized Official Contact | 3603309044 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cascade Mental Health Care 2428 W Reynolds Ave Centralia WA 98531-4554 Ph: (360) 330-9044 | Cascade Mental Health Care 2428 W Reynolds Ave Centralia WA 98531 Ph: (360) 330-9044 |
NPI Number | 1619068624 |
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Provider Enumeration Date | 09/27/2006 |
Last Update Date | 07/16/2024 |
Certification Date | 07/16/2024 |
Medicare PECOS PAC ID | 5496641177 |
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Medicare Enrollment ID | O20040227000824 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619068624 | NPI | - | NPPES |
7035090 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
Provider Name | Roy W Schlegel |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1942300736 PECOS PAC ID: 6800823816 Enrollment ID: I20050721000376 |
Provider Name | Jeremy K Greenwood |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1750449013 PECOS PAC ID: 3375702194 Enrollment ID: I20120313000925 |
Provider Name | Minerva D Arrienda |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1629071964 PECOS PAC ID: 2567613987 Enrollment ID: I20121113000261 |
Provider Name | Tracy P Svoboda |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861733529 PECOS PAC ID: 6406095843 Enrollment ID: I20141213000344 |
Provider Name | Cheryl M Mercurio |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588085443 PECOS PAC ID: 5799095519 Enrollment ID: I20151106002216 |
Provider Name | Luke C Greene |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134423056 PECOS PAC ID: 1355586033 Enrollment ID: I20161206001098 |
Provider Name | Lisa M Archer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043648702 PECOS PAC ID: 0840511960 Enrollment ID: I20191220001486 |
Provider Name | Teresa J Ekdahl-johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386258697 PECOS PAC ID: 3173934569 Enrollment ID: I20201116000207 |
Provider Name | Angelina Suzanne Campos |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104467042 PECOS PAC ID: 5597190710 Enrollment ID: I20210902000824 |
Provider Name | Traci A Levesque |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982061628 PECOS PAC ID: 0648637926 Enrollment ID: I20230531003162 |
Provider Name | Russell O Funk |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1467505636 PECOS PAC ID: 6709239270 Enrollment ID: I20240131003593 |
Provider Name | Wangari Gathungu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902316086 PECOS PAC ID: 0840626024 Enrollment ID: I20240131004086 |
Provider Name | Deborah D Ingram |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1700354099 PECOS PAC ID: 4880047372 Enrollment ID: I20240131004400 |
Provider Name | Leann J Reed |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1376965475 PECOS PAC ID: 6002269503 Enrollment ID: I20240131004593 |
Provider Name | Dianna L Padgett |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1720483654 PECOS PAC ID: 2264885763 Enrollment ID: I20240131004634 |
Provider Name | Duane E Patterson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154054344 PECOS PAC ID: 3971956483 Enrollment ID: I20240131004736 |
Provider Name | Tony J Meinhardt |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1790265312 PECOS PAC ID: 3274986641 Enrollment ID: I20240201002155 |
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