Healthcare Provider Details

I. General information

NPI: 1184040636
Provider Name (Legal Business Name): RAIN FIELD COUNSELING & CONSULTING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2014
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S GRADY WAY STE LL25
RENTON WA
98057-3218
US

IV. Provider business mailing address

15 S GRADY WAY STE LL25
RENTON WA
98057-3218
US

V. Phone/Fax

Practice location:
  • Phone: 425-291-7581
  • Fax:
Mailing address:
  • Phone: 425-291-7581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17-1611-00
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17-1611-00
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17-1611-00
License Number StateWA

VIII. Authorized Official

Name: ANDREW W WINSTEAD
Title or Position: CEO
Credential:
Phone: 425-291-7581