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General NPI Number Information
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NPI Number | 1053621144
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Entity Type | Organization
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Legal Business Name | SUCCESS ABROAD COUNSELING, LLC
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 10212 5TH AVE NE SUITE 150
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City | SEATTLE
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State | WA
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Zip | 98125-7452
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Country | US
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Telephone | 206-418-0600
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Fax | 206-418-0612
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Provider Business Mailing Address
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Address Line | 10212 5TH AVE NE SUITE 150
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City | SEATTLE
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State | WA
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Zip | 98125-7452
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Country | US
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Telephone | 206-418-0600
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Fax | 206-418-0612
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Authorized Official
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Title or Position | OWNER
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Name | KIYOKO KAKUTANI
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Credential | MSW
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Telephone | 206-418-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 602826032
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License Number State | WA
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