MEDICARE: FICUS COUNSELING, PLLC DBA CASCARA COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558135350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FICUS COUNSELING, PLLC DBA CASCARA COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	1667 14TH ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-8503
Country	:	US
Telephone Number	:	206-390-1474
Fax Number	:	360-550-9508

Provider Business Practice Location Address
First Line	:	1667 14TH ST
Second Line	:
City	:	PORT TOWNSEND
State	:	WA
Zip	:	98368-8503
Country	:	US
Telephone Number	:	206-390-1474
Fax Number	:	360-550-9508

Authorized Official
Title or Position	:	LICENSED COUNSELOR
Name	:	MR. GREGORY VAUGHN DEKLEVER
Credential	:	LICSW
Telephone Number	:	206-390-1474

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	03/03/2026

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