MIKKADESH MENTAL HEALTHCARE LLC
NPI 1063120020
Nurse Practitioner - Psychiatric/Mental Health in Puyallup, WA
About Mikkadesh Mental Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIKKADESH MENTAL HEALTHCARE LLC (NPI 1063120020) is a healthcare organization registered as a psychiatric/mental health in Puyallup, Washington and active in the NPI registry since November 2022. The organization lists Veronica Abeh Forchu, President/administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mikkadesh Mental Healthcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Mikkadesh Mental Healthcare LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mikkadesh Mental Healthcare LLC's NPI number?
The NPI number for Mikkadesh Mental Healthcare LLC is 1063120020. It was assigned to this organization in the NPPES registry on November 9, 2022.
Where is Mikkadesh Mental Healthcare LLC located?
Mikkadesh Mental Healthcare LLC is located at 12923 Emerald Ridge Blvd E, Puyallup, WA 98374. The listed phone number is (801) 649-7584.
What is Mikkadesh Mental Healthcare LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mikkadesh Mental Healthcare LLC enrolled in Medicare?
Yes. Mikkadesh Mental Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mikkadesh Mental Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mikkadesh Mental Healthcare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Mikkadesh Mental Healthcare LLC accept?
Health plans from BridgeSpan Health Company, Premera Blue Cross Blue Shield of Alaska and Regence BlueCross BlueShield of Utah list Mikkadesh Mental Healthcare LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mikkadesh Mental Healthcare LLC was last updated on December 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mikkadesh Mental Healthcare Llc · NPI 1063120020
Psychiatric/Mental Health organization in Puyallup, Washington. Organization record, active in the CMS NPPES registry since November 9, 2022.
## Identity
- **NPI:** 1063120020 (Entity type: Organization)
- **Enumerated:** November 9, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Also known as:** Mikkadesh Mental Healthcare LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Veronica Forchu, PRESIDENT/ADMINISTRATOR
## Practice location
- **Address:** 12923 EMERALD RIDGE BLVD E, Puyallup, WA 98374-8403
- **Phone:** (801) 649-7584
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063120020) · Data from the CMS NPPES public registry.