Provider Demographics
NPI:1134650427
Name:TELECARE MENTAL HEALTH SERVICES OF WASHINGTON INC
Entity Type:Organization
Organization Name:TELECARE MENTAL HEALTH SERVICES OF WASHINGTON INC
Other - Org Name:NORTH SOUND PEER BRIDGER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-337-7950
Mailing Address - Street 1:1080 MARINA VILLAGE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1078
Mailing Address - Country:US
Mailing Address - Phone:510-337-7950
Mailing Address - Fax:510-337-7969
Practice Address - Street 1:1803 N SOUND DR
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-7697
Practice Address - Country:US
Practice Address - Phone:360-854-7400
Practice Address - Fax:360-854-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health