Healthcare Provider Details
I. General information
NPI: 1104174465
Provider Name (Legal Business Name): NUA COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2012
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2505 3RD AVE SUITE 325
SEATTLE WA
98121-3418
US
IV. Provider business mailing address
2505 3RD AVE SUITE 325
SEATTLE WA
98121-3418
US
V. Phone/Fax
- Phone: 206-905-4667
- Fax:
- Phone: 206-905-4667
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | CDP00004561 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LH00010987 |
| License Number State | WA |
VIII. Authorized Official
Name: MS.
ERIN
LYNCH
Title or Position: ADMINISTRATOR
Credential: LMHC, CDP, MAC
Phone: 206-905-4667