Healthcare Provider Details

I. General information

NPI: 1558675876
Provider Name (Legal Business Name): DBA FOR ALL CHILDREN AND FAMILIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 06/17/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 NORTH 16TH AVENUE SUITE G
YAKIMA WA
98902-7102
US

IV. Provider business mailing address

1460 NORTH 16TH AVENUE SUITE G SUITE G
YAKIMA WA
98902-7102
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-7750
  • Fax: 509-575-7796
Mailing address:
  • Phone: 509-575-7750
  • Fax: 509-575-7796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 00010211
License Number StateWA

VIII. Authorized Official

Name: KAREN KAE CYR
Title or Position: SOLE PROPRIETOR LMHC
Credential: M.ED.
Phone: 509-575-7750