HOLOS MENTAL HEALTHCARE LLC
NPI 1104613595
Nurse Practitioner - Psychiatric/Mental Health in Lakebay, WA
About Holos Mental Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOLOS MENTAL HEALTHCARE LLC (NPI 1104613595) is a healthcare organization registered as a psychiatric/mental health in Lakebay, Washington and active in the NPI registry since April 2025. The organization lists Kate Teague, Credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Holos Mental Healthcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Holos Mental Healthcare LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Holos Mental Healthcare LLC's NPI number?
The NPI number for Holos Mental Healthcare LLC is 1104613595. It was assigned to this organization in the NPPES registry on April 21, 2025.
Where is Holos Mental Healthcare LLC located?
Holos Mental Healthcare LLC is located at 17713 Herron Rd NW, Lakebay, WA 98349. The listed phone number is (253) 380-1248.
What is Holos 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 Holos Mental Healthcare LLC enrolled in Medicare?
Yes. Holos Mental Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Holos Mental Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Holos 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Holos Mental Healthcare LLC was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Holos Mental Healthcare Llc · NPI 1104613595
Psychiatric/Mental Health organization in Lakebay, Washington. Organization record, active in the CMS NPPES registry since April 21, 2025.
## Identity
- **NPI:** 1104613595 (Entity type: Organization)
- **Enumerated:** April 21, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Kate Teague, CREDENTIALING
## Practice location
- **Address:** 17713 HERRON RD NW, Lakebay, WA 98349-9808
- **Phone:** (253) 380-1248
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104613595) · Data from the CMS NPPES public registry.