Healthcare Provider Details

I. General information

NPI: 1699153767
Provider Name (Legal Business Name): TENACITY COUNSELING AND COURT SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16113 DENSMORE AVE N
SHORELINE WA
98133-5828
US

IV. Provider business mailing address

PO BOX 77062
SEATTLE WA
98177-0062
US

V. Phone/Fax

Practice location:
  • Phone: 206-696-1565
  • Fax:
Mailing address:
  • Phone: 206-696-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLH60102069
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberLH60102069
License Number StateWA

VIII. Authorized Official

Name: MS. MARINA HORSTING
Title or Position: MEMBER
Credential: M.A.
Phone: 206-696-1565