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Active NPI 1477978849 Organization (Entity Type 2)

Mindsource Center, Llc

Community/Behavioral Health • Covington, WA

About Mindsource Center, Llc NPI 1477978849 Summary

Mindsource Center, Llc is a verified healthcare organization specializing in Community/Behavioral Health operating in Covington, WA. Located at 27023 164TH AVE SE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1477978849.

Administrative operations and authorized compliance are overseen by Caroline Sheppard (Director).

The facility is associated with 20 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

27023 164th Ave Se

Covington, WA 980428241

Telephone 2536397146
Fax 2536397145

Authorized Official Information

Authorized Contact Name

Caroline Sheppard

Title / Role

Director

Official Telephone

2533500661

Facility Classifications & Specialties

Community/Behavioral Health Primary Taxonomy

NUCC Taxonomy Code: 251S00000X

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

20 Linked

Counselor - Mental Health

Covington, WA

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Jenelle Bartlett NPI 1134559859

Behavior Analyst

Covington, WA

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Behavior Analyst

Covington, WA

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Behavior Analyst

Covington, WA

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Louise Harris , LMHC NPI 1225069933

Counselor

Covington, WA

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Behavior Technician

Covington, WA

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Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active February 21, 2014

NPI status registered as active in NPPES database

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Updated Practice Location February 21, 2014

Registered at 27023 164TH AVE SE, COVINGTON, WA 980428241 (Tel: 2536397146)

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Updated Business Mailing Address February 21, 2014

Registered at 27023 164TH AVE SE, COVINGTON, WA 980428241 (Tel: 2536397146)

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Organization / Clinic Name Updated February 21, 2014

Operating as MINDSOURCE CENTER, LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2014

Community/Behavioral Health (License #025 in WA)

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Initial NPI Registration & Enumeration February 21, 2014

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1477978849
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: February 21, 2014
Last Update: February 21, 2014

Mailing Address

27023 164th Ave Se

Covington, WA 980428241

Phone: 2536397146

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.