Healthcare Provider Details

I. General information

NPI: 1477610368
Provider Name (Legal Business Name): ASSOCIATED BEHAVIORAL HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4711 44TH AVE SE SUITE A
SEATTLE WA
98116-4591
US

IV. Provider business mailing address

1800 112TH AVE NE SUITE 150
BELLEVUE WA
98004-2993
US

V. Phone/Fax

Practice location:
  • Phone: 206-935-1282
  • Fax: 425-671-6496
Mailing address:
  • Phone: 425-646-7279
  • Fax: 425-646-7499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number045600
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER BARD
Title or Position: CEO
Credential: CDP
Phone: 425-646-7279