Healthcare Provider Details

I. General information

NPI: 1205466265
Provider Name (Legal Business Name): HARBOR YOUTH AND FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 CHRISTENSEN RD STE 200
TUKWILA WA
98188-2925
US

IV. Provider business mailing address

16000 NE CHRISTENSEN DR SUITE 200
TUKWILA WA
98188
US

V. Phone/Fax

Practice location:
  • Phone: 833-719-0886
  • Fax: 702-589-4872
Mailing address:
  • Phone: 702-589-4871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KRISTA HUEY
Title or Position: DIRECTOR OF CCRCM
Credential: MBA, MHA
Phone: 702-528-9947