Provider Demographics
NPI:1932473238
Name:ASSOCIATES FOR PSYCHIATRIC & MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:ASSOCIATES FOR PSYCHIATRIC & MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHOPPALA-NESTOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PMHNP-BC, ARNP
Authorized Official - Phone:360-448-7827
Mailing Address - Street 1:2600 F STREET
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663
Mailing Address - Country:US
Mailing Address - Phone:360-448-7827
Mailing Address - Fax:503-914-1404
Practice Address - Street 1:2600 F STREET
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663
Practice Address - Country:US
Practice Address - Phone:360-448-7827
Practice Address - Fax:503-914-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-04
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA200344261Q00000X, 261QM0801X
WAAP60035777261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)