MEDICARE: A WALK TO FREEDOM COUNSELING, 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	2084P0800X	Psychiatry Physician
2	251S00000X	Community/Behavioral Health Agency
3	261QM0850X	Adult Mental Health Clinic/Center
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
5	101Y00000X	Counselor
6	101YA0400X	Addiction (Substance Use Disorder) Counselor	CO60750267	WA
7	101YM0800X	Mental Health Counselor	LH60887874	WA
8	101YM0800X	Mental Health Counselor
9	104100000X	Social Worker
10	106H00000X	Marriage & Family Therapist
11	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1740763648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WALK TO FREEDOM COUNSELING, LLC

Provider Business Mailing Address
First Line	:	921 HARVEY RD NE STE C
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98002-4294
Country	:	US
Telephone Number	:	253-939-2211
Fax Number	:	253-939-2867

Provider Business Practice Location Address
First Line	:	921 HARVEY RD NE STE C
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98002-4294
Country	:	US
Telephone Number	:	253-939-2211
Fax Number	:	253-939-2867

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MS. LYNN DALE DALSING
Credential	:
Telephone Number	:	253-939-2211

Provider Enumeration Date	:	09/07/2018
Last Update Date	:	07/27/2023

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