Healthcare Provider Details
I. General information
NPI: 1760205207
Provider Name (Legal Business Name): HUCKLEBERRY BEHAVIORAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2024
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
613 19TH AVE E STE 200
SEATTLE WA
98112-4075
US
IV. Provider business mailing address
3105 E PINE ST
SEATTLE WA
98122-3263
US
V. Phone/Fax
- Phone: 206-631-0274
- Fax: 206-374-2547
- Phone: 206-631-0274
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WHITNEY
MORGAN
YOUNG
Title or Position: OWNER
Credential: BCBA, LBA
Phone: 206-631-0274