Healthcare Provider Details

I. General information

NPI: 1407404965
Provider Name (Legal Business Name): ISLAND OF HOPE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 SE BARRINGTON DR
OAK HARBOR WA
98277-3200
US

IV. Provider business mailing address

PO BOX 1278
LINCOLNTON NC
28093-1278
US

V. Phone/Fax

Practice location:
  • Phone: 425-954-5659
  • Fax: 425-230-4888
Mailing address:
  • Phone: 425-954-5659
  • Fax: 425-230-4884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TODD M WEBB
Title or Position: SOLE MEMBER
Credential: M. ED.
Phone: 360-682-4605