| Pilgrim Behavioral Health | |
|
4405 7th Avenue Ste 200 Lacey WA 98503 | |
| (505) 501-8293 | |
| (505) 521-5149 |
| Full Name | Pilgrim Behavioral Health |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4405 7th Avenue Ste 200, Lacey, Washington |
| Authorized Official Name and Position | Misty Pilgrim (OWNER, CLINICAL DIRECTOR) |
| Authorized Official Contact | 5055018293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pilgrim Behavioral Health 46 Village Way # 107 Port Ludlow WA 98365-5102 Ph: (505) 501-8293 | Pilgrim Behavioral Health 4405 7th Avenue Ste 200 Lacey WA 98503 Ph: (505) 501-8293 |
| NPI Number | 1568137370 |
|---|---|
| Provider Enumeration Date | 08/13/2021 |
| Last Update Date | 07/23/2024 |
| Certification Date | 05/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568137370 | NPI | - | NPPES |
| 44002335 | Medicaid | NM | |
| 1568137370 | Medicaid | NM | |
| 007433 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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