MEDICARE: DBA FOR ALL CHILDREN AND FAMILIES LLC

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	LH 00010211	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558675876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DBA FOR ALL CHILDREN AND FAMILIES LLC

Provider Business Mailing Address
First Line	:	1460 NORTH 16TH AVENUE SUITE G
Second Line	:	SUITE G
City	:	YAKIMA
State	:	WA
Zip	:	98902-7102
Country	:	US
Telephone Number	:	509-575-7750
Fax Number	:	509-575-7796

Provider Business Practice Location Address
First Line	:	1460 NORTH 16TH AVENUE
Second Line	:	SUITE G
City	:	YAKIMA
State	:	WA
Zip	:	98902-7102
Country	:	US
Telephone Number	:	509-575-7750
Fax Number	:	509-575-7796

Authorized Official
Title or Position	:	SOLE PROPRIETOR LMHC
Name	:	KAREN KAE CYR
Credential	:	M.ED.
Telephone Number	:	509-575-7750

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	06/17/2024

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