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General NPI Number Information
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NPI Number | 1043080807
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Entity Type | Organization
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Legal Business Name | HALCYON COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 10818 NE COXLEY DR STE O
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City | VANCOUVER
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State | WA
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Zip | 98662-6163
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Country | US
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Telephone | 360-559-1468
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Fax |
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Provider Business Mailing Address
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Address Line | 10818 NE COXLEY DR STE O
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City | VANCOUVER
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State | WA
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Zip | 98662-6163
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Country | US
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Telephone | 360-559-1468
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | ANNA GAVRISHOVA
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Credential |
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Telephone | 360-559-1468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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