Healthcare Provider Details

I. General information

NPI: 1053075986
Provider Name (Legal Business Name): SOSA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25029 144TH PL SE
KENT WA
98042-3425
US

IV. Provider business mailing address

25029 144TH PL SE
KENT WA
98042-3425
US

V. Phone/Fax

Practice location:
  • Phone: 650-922-3049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN SOSA
Title or Position: OWNER
Credential: LMHCA
Phone: 253-642-6127