| Cascade Neuropsychology, Pllc | |
|
12 Bellwether Way Ste 240 Bellingham WA 98225-2959 | |
| (360) 588-2500 | |
| (360) 785-2016 |
| Full Name | Cascade Neuropsychology, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 12 Bellwether Way Ste 240, Bellingham, Washington |
| Authorized Official Name and Position | Kelly L Crenshaw (OWNER) |
| Authorized Official Contact | 3605882500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Neuropsychology, Pllc 12 Bellwether Way Ste 240 Bellingham WA 98225-2959 Ph: (360) 588-2500 | Cascade Neuropsychology, Pllc 12 Bellwether Way Ste 240 Bellingham WA 98225-2959 Ph: (360) 588-2500 |
| NPI Number | 1871099937 |
|---|---|
| Provider Enumeration Date | 04/05/2018 |
| Last Update Date | 07/26/2024 |
| Certification Date | 07/26/2024 |
| Medicare PECOS PAC ID | 2961767512 |
|---|---|
| Medicare Enrollment ID | O20201229001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871099937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Kelly Lynn Crenshaw |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649694662 PECOS PAC ID: 6709000615 Enrollment ID: I20210104001987 |
| Provider Name | Jennifer R Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780833004 PECOS PAC ID: 1759502693 Enrollment ID: I20210303003028 |
| Provider Name | Carmen C Velazquez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669621926 PECOS PAC ID: 4486974946 Enrollment ID: I20211013001379 |
| Provider Name | Jaleesa Shears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508478066 PECOS PAC ID: 5294148961 Enrollment ID: I20220621003119 |
| Provider Name | Marie Lisa Skanis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427729623 PECOS PAC ID: 6709230873 Enrollment ID: I20230922001054 |
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