Provider Demographics
NPI:1154160216
Name:REBECCA MUIRHEAD PSYD, PLLC
Entity type:Organization
Organization Name:REBECCA MUIRHEAD PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:MUIRHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:253-308-8160
Mailing Address - Street 1:920 ALDER AVE STE 203A
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-1458
Mailing Address - Country:US
Mailing Address - Phone:253-308-8160
Mailing Address - Fax:
Practice Address - Street 1:920 ALDER AVE STE 203A
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1458
Practice Address - Country:US
Practice Address - Phone:253-308-8160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health