| Greater Lakes Mental Healthcare | |
|
9330 59th Ave Sw Lakewood WA 98499-2858 | |
| (253) 581-7020 | |
| (253) 620-5149 |
| Full Name | Greater Lakes Mental Healthcare |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 9330 59th Ave Sw, Lakewood, Washington |
| Authorized Official Name and Position | William Glenn Czerwinski (COO) |
| Authorized Official Contact | 2536205134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Lakes Mental Healthcare 9330 59th Ave Sw Lakewood WA 98499-2858 Ph: (253) 581-7020 | Greater Lakes Mental Healthcare 9330 59th Ave Sw Lakewood WA 98499-2858 Ph: (253) 581-7020 |
| NPI Number | 1225039811 |
|---|---|
| Provider Enumeration Date | 08/03/2005 |
| Last Update Date | 01/07/2022 |
| Certification Date | 01/07/2022 |
| Medicare PECOS PAC ID | 7315836350 |
|---|---|
| Medicare Enrollment ID | O20040315001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225039811 | NPI | - | NPPES |
| 1043327 | Medicaid | WA |
| Provider Name | Paul David Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508868274 PECOS PAC ID: 6204734064 Enrollment ID: I20031230000731 |
| Provider Name | Eileen L Poupore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639158223 PECOS PAC ID: 0941292395 Enrollment ID: I20040402001046 |
| Provider Name | Mary E Langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295895704 PECOS PAC ID: 1658361357 Enrollment ID: I20040514000668 |
| Provider Name | Helen Elizabeth Munn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437214129 PECOS PAC ID: 6901896406 Enrollment ID: I20040517000409 |
| Provider Name | Teresa M Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235159484 PECOS PAC ID: 4587621438 Enrollment ID: I20100111000156 |
| Provider Name | Joseph P Tomsic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801149851 PECOS PAC ID: 0840443818 Enrollment ID: I20121227000315 |
| Provider Name | Stephanie R Blum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104092857 PECOS PAC ID: 0042455891 Enrollment ID: I20130326000534 |
| Provider Name | Courtney R Morley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922358183 PECOS PAC ID: 8426297805 Enrollment ID: I20130614000380 |
| Provider Name | Russell D Hicks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215905302 PECOS PAC ID: 3072736032 Enrollment ID: I20140519002332 |
| Provider Name | Donna J Brazel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942314000 PECOS PAC ID: 6507085248 Enrollment ID: I20140911001791 |
| Provider Name | Elizabeth Rose Irons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558811570 PECOS PAC ID: 1850672304 Enrollment ID: I20161221001847 |
| Provider Name | Brittany Pauline Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073024774 PECOS PAC ID: 7719244623 Enrollment ID: I20171201000807 |
| Provider Name | Annabelle T Vo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699286336 PECOS PAC ID: 0840557443 Enrollment ID: I20171207001226 |
| Provider Name | Percy Lee Lynchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881108553 PECOS PAC ID: 0244598472 Enrollment ID: I20171218001452 |
| Provider Name | Mary Mina Flake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972960227 PECOS PAC ID: 3870855208 Enrollment ID: I20180324000130 |
| Provider Name | Lesya Sergeyevna Bindas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396300984 PECOS PAC ID: 8729411004 Enrollment ID: I20191126002655 |
| Provider Name | Odessa Ann Bacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801077169 PECOS PAC ID: 4688008519 Enrollment ID: I20191230001940 |
| Provider Name | Sarah Marie Mendenhall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124471974 PECOS PAC ID: 7315373552 Enrollment ID: I20200205003034 |
| Provider Name | Alimatou Moustapha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316588619 PECOS PAC ID: 3072941582 Enrollment ID: I20200317000417 |
| Provider Name | Tracie Lynne Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669016093 PECOS PAC ID: 9830528728 Enrollment ID: I20200327001458 |
| Provider Name | Benson Elliott Bagwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639703820 PECOS PAC ID: 7618307893 Enrollment ID: I20200501001042 |
| Provider Name | Cheryl Chua Dann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225673817 PECOS PAC ID: 4981002839 Enrollment ID: I20211007002188 |
| Provider Name | Rebecca Helen Shide-ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811464142 PECOS PAC ID: 4789075029 Enrollment ID: I20211222000320 |
| Provider Name | Larisa Sopka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932700465 PECOS PAC ID: 7416349113 Enrollment ID: I20220107002040 |
| Provider Name | Erykah Patrice Sutton-hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255513370 PECOS PAC ID: 5698162279 Enrollment ID: I20220429000188 |
| Provider Name | Erin Devyak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275052144 PECOS PAC ID: 7618359449 Enrollment ID: I20220726003711 |
| Provider Name | James Mcallister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942769328 PECOS PAC ID: 8820328982 Enrollment ID: I20220803002841 |
| Provider Name | Tiffani Strickland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912467283 PECOS PAC ID: 9931581030 Enrollment ID: I20220805002784 |
| Provider Name | Bryan Lazaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912458845 PECOS PAC ID: 4880976521 Enrollment ID: I20220831003867 |
| Provider Name | David Falikovici |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760059695 PECOS PAC ID: 6800271453 Enrollment ID: I20220916002670 |
| Provider Name | Linda Jean Trader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356987739 PECOS PAC ID: 0840666772 Enrollment ID: I20221018003063 |
| Provider Name | Asurupi Gurung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093254518 PECOS PAC ID: 3072898493 Enrollment ID: I20221114002944 |
| Provider Name | Pamela Handran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154885259 PECOS PAC ID: 7618346131 Enrollment ID: I20221206000110 |
| Provider Name | Carla Clyde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619375789 PECOS PAC ID: 9830560440 Enrollment ID: I20230118002000 |
| Provider Name | April Novotny-cardenas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275143042 PECOS PAC ID: 2961858022 Enrollment ID: I20231025002127 |
| Provider Name | Autumn Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841677127 PECOS PAC ID: 2365898335 Enrollment ID: I20231026003500 |
| Provider Name | Rhiannon Whited |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124534094 PECOS PAC ID: 0648626580 Enrollment ID: I20231027002998 |
| Provider Name | Ranju Kharel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609589274 PECOS PAC ID: 0941659957 Enrollment ID: I20231214003706 |
| Provider Name | Lauren Ann Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225559867 PECOS PAC ID: 5395195499 Enrollment ID: I20240102003610 |
| Provider Name | Erin Kristina Rohrbough |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801405402 PECOS PAC ID: 9638520232 Enrollment ID: I20240108005844 |
| Provider Name | Christopher Prather |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134513799 PECOS PAC ID: 9133570732 Enrollment ID: I20240108006071 |
| Provider Name | William Harold Eubanks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689799942 PECOS PAC ID: 7810348398 Enrollment ID: I20240109002729 |
| Provider Name | Kevin Martin Larson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467797126 PECOS PAC ID: 1052762481 Enrollment ID: I20240110000114 |
| Provider Name | Chloe Wilmarth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487064671 PECOS PAC ID: 4284085655 Enrollment ID: I20240110001639 |
| Provider Name | Mark Alan Horan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487770517 PECOS PAC ID: 3476905563 Enrollment ID: I20240112004157 |
| Provider Name | Heather Lea Marsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003098229 PECOS PAC ID: 6103278296 Enrollment ID: I20240112004167 |
| Provider Name | Amy Regina Linehan Leister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508314188 PECOS PAC ID: 9032561071 Enrollment ID: I20240116001515 |
| Provider Name | Sally A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558641878 PECOS PAC ID: 1153773031 Enrollment ID: I20240116003091 |
| Provider Name | Brandon Ross Muller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477048395 PECOS PAC ID: 8123470051 Enrollment ID: I20240116004698 |
| Provider Name | Kathryn Willis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013432848 PECOS PAC ID: 9638521560 Enrollment ID: I20240117000146 |
| Provider Name | Kelsey Elizabeth Corley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851746648 PECOS PAC ID: 1153773999 Enrollment ID: I20240117003840 |
| Provider Name | Marci Mcclure |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194126359 PECOS PAC ID: 0648622076 Enrollment ID: I20240122000879 |
| Provider Name | Jamie Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649632688 PECOS PAC ID: 5597117820 Enrollment ID: I20240123000030 |
| Provider Name | Ananda Duprey Leininger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629535554 PECOS PAC ID: 0345692554 Enrollment ID: I20240123002755 |
| Provider Name | James A Ruvalcaba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518340728 PECOS PAC ID: 5597054197 Enrollment ID: I20240125004712 |
| Provider Name | Michael Wong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518514389 PECOS PAC ID: 4183067739 Enrollment ID: I20240209003761 |
| Provider Name | Timothy Wecks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578805107 PECOS PAC ID: 4082057484 Enrollment ID: I20240213000002 |
| Provider Name | James Rose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487162640 PECOS PAC ID: 5294179453 Enrollment ID: I20240215004355 |
Light Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9124 Gravelly Lake Dr Sw, Lakes Plaza Suite 101, Lakewood, WA 98499 Phone: 253-503-0236 Fax: 253-503-0982 | |
Reflections Recovery And Learning Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8907 Gravelly Lake Dr Sw Ste D, Lakewood, WA 98499 Phone: 253-581-5556 | |
Paul Kenneth Henry Med Lmhc Ps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9101 Bridgeport Way Sw Ste D2, Lakewood, WA 98499 Phone: 253-394-6045 | |
Ame Higher Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4606 108th St Sw, Lakewood, WA 98499 Phone: 253-693-2626 | |
Franciscan Psychology-neuropsychology Services @ St Clare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4908 112th St Sw, Lakewood, WA 98499 Phone: 253-985-6560 Fax: 253-985-6561 | |
Lakewood Wellness Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10310 Gravelly Lake Dr Sw Ste B, Lakewood, WA 98499 Phone: 253-888-3405 | |
Asian Counseling Treatment Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9102 Bridgeport Way Sw, Lakewood, WA 98499 Phone: 253-302-3826 Fax: 253-267-5212 |