Healthcare Provider Details

I. General information

NPI: 1073639753
Provider Name (Legal Business Name): CASTEELE, WILLIAMS & ASSOCIATES COUNSELING AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8833 PACIFIC AVE STE D
TACOMA WA
98444-6490
US

IV. Provider business mailing address

8833 PACIFIC AVE STE D
TACOMA WA
98444-6490
US

V. Phone/Fax

Practice location:
  • Phone: 253-536-2881
  • Fax: 253-536-2956
Mailing address:
  • Phone: 253-536-2881
  • Fax: 253-536-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberLF00001490
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberCP00002471
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License NumberCP00002471
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLF00001490
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN L CASTEELE JR.
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 253-536-2881