Healthcare Provider Details

I. General information

NPI: 1184405052
Provider Name (Legal Business Name): EVIDENCE BASED THERAPY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14645 NE BEL RED RD STE 203
BELLEVUE WA
98007-3929
US

IV. Provider business mailing address

3416 161ST CT SE APT 35
BELLEVUE WA
98008-5763
US

V. Phone/Fax

Practice location:
  • Phone: 425-202-5439
  • Fax:
Mailing address:
  • Phone: 425-202-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CASEY MCGINNIS
Title or Position: OWNER
Credential: PHD
Phone: 425-202-5439