Provider Demographics
NPI:1225158769
Name:LUMMI INDIAN BUSINESS COUNCIL
Entity Type:Organization
Organization Name:LUMMI INDIAN BUSINESS COUNCIL
Other - Org Name:LUMMI BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTHCARE BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:360-312-2285
Mailing Address - Street 1:2592 KWINA RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9278
Mailing Address - Country:US
Mailing Address - Phone:360-384-0464
Mailing Address - Fax:
Practice Address - Street 1:2665 KWINA RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9291
Practice Address - Country:US
Practice Address - Phone:360-312-2019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUMMI INDIAN BUSINESS COUNCIL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-29
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1980846Medicaid