Healthcare Provider Details
I. General information
NPI: 1366674129
Provider Name (Legal Business Name): CARING PRESENCE PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1530 N 115TH ST STE 207
SEATTLE WA
98133-8411
US
IV. Provider business mailing address
PO BOX 11009
OLYMPIA WA
98508-1009
US
V. Phone/Fax
- Phone: 206-367-3058
- Fax: 206-523-1252
- Phone: 206-367-3058
- Fax: 206-523-1252
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LF0000863 |
| License Number State | WA |
VIII. Authorized Official
Name:
CAROLYN
G
RODENBERG
Title or Position: OWNER
Credential: MA
Phone: 206-367-3058