Healthcare Provider Details

I. General information

NPI: 1205508157
Provider Name (Legal Business Name): AVOIDING THE COUCH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 COOKS HILL RD
CENTRALIA WA
98531
US

IV. Provider business mailing address

1807 COOKS HILL RD
CENTRALIA WA
98531
US

V. Phone/Fax

Practice location:
  • Phone: 253-999-9079
  • Fax: 253-368-0502
Mailing address:
  • Phone: 253-999-9079
  • Fax: 253-368-0502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA R GEIST
Title or Position: OWNER
Credential: LMHC
Phone: 360-623-0271