Basic Information
| Provider Information | |||||||||
| NPI: | 1750823662 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SEATTLE SOCIAL WORK AND COUNSELING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7414 S 128TH ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981784346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585983713 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1812 E MADISON ST | ||||||||
| Address2: | #202 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981222843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585983713 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2016 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | WILDE | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOCIAL WORKER/COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 8585983713 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | LW60543263 | WA | N | Agencies | Case Management | 251S00000X | LW60543263 | WA | Y | Agencies | Community/Behavioral Health |
No ID Information.