Healthcare Provider Details

I. General information

NPI: 1063914505
Provider Name (Legal Business Name): DRAYTON FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 KING ST
BELLINGHAM WA
98229-6263
US

IV. Provider business mailing address

4576 CALIFORNIA TRL
BLAINE WA
98230-9790
US

V. Phone/Fax

Practice location:
  • Phone: 360-223-3224
  • Fax:
Mailing address:
  • Phone: 360-223-3224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: DR. CHRIS COCHRAN
Title or Position: THERAPIST
Credential: EDD LMHCA
Phone: 360-223-3224