Healthcare Provider Details

I. General information

NPI: 1861097065
Provider Name (Legal Business Name): RESOURCE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 FRONT ST STE D
LYNDEN WA
98264-1935
US

IV. Provider business mailing address

517 FRONT ST STE D
LYNDEN WA
98264-1935
US

V. Phone/Fax

Practice location:
  • Phone: 360-890-0055
  • Fax:
Mailing address:
  • Phone: 360-890-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WESLY WOODSON WYNN
Title or Position: OWNER/THERAPIST
Credential: LMHC
Phone: 360-890-0055