| Valley Psychological Services | |
|
2109 W Dolarway Rd Ellensburg WA 98926-9367 | |
| (509) 968-5086 | |
| (844) 755-6412 |
| Full Name | Valley Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 2109 W Dolarway Rd, Ellensburg, Washington |
| Authorized Official Name and Position | Lisa Martin (OWNER / PSYCHOLOGIST) |
| Authorized Official Contact | 5092011616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Psychological Services 2109 W Dolarway Rd Ellensburg WA 98926-9367 Ph: (509) 968-5086 | Valley Psychological Services 2109 W Dolarway Rd Ellensburg WA 98926-9367 Ph: (509) 968-5086 |
| NPI Number | 1356842785 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 3274897665 |
|---|---|
| Medicare Enrollment ID | O20180511001104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356842785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY60253453 (Washington) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | Lisa Marie Godfrey Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427319052 PECOS PAC ID: 8628234556 Enrollment ID: I20120723000260 |
| Provider Name | Jamie L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710058839 PECOS PAC ID: 0446498075 Enrollment ID: I20130521000368 |
| Provider Name | Carolyn Sims Cleveland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912380692 PECOS PAC ID: 2264796655 Enrollment ID: I20180511001303 |
| Provider Name | Bradley D Bastian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790173318 PECOS PAC ID: 4688917008 Enrollment ID: I20190528000660 |
| Provider Name | Alexis Moore |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285353540 PECOS PAC ID: 9830566876 Enrollment ID: I20221104001242 |
| Provider Name | Olivia Grace Holter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831861079 PECOS PAC ID: 1759751993 Enrollment ID: I20230103002895 |
| Provider Name | Jeanette Rendina |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770999435 PECOS PAC ID: 4880065564 Enrollment ID: I20230116000768 |
| Provider Name | Mary L Day |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871676726 PECOS PAC ID: 6305388406 Enrollment ID: I20240604003783 |
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