Healthcare Provider Details

I. General information

NPI: 1871992800
Provider Name (Legal Business Name): ALLIED FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4509 TALBOT RD S SUITE 105
RENTON WA
98055-6294
US

IV. Provider business mailing address

4509 TALBOT RD S SUITE 105
RENTON WA
98055-6294
US

V. Phone/Fax

Practice location:
  • Phone: 425-429-2230
  • Fax:
Mailing address:
  • Phone: 425-429-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCL60506066
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateWA

VIII. Authorized Official

Name: LAURAMAERY (GOLD) POST
Title or Position: CERTIFIED COUNSELOR
Credential: CC, BS
Phone: 425-429-2230