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General NPI Number Information
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NPI Number | 1053782078
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Entity Type | Organization
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Legal Business Name | REAL LIFE COUNSELING PLLC
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Dates
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Enumeration Date | 10/16/2015
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1498 SE TECH CENTER PL STE 300
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City | VANCOUVER
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State | WA
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Zip | 98683-5509
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Country | US
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Telephone | 360-619-2226
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Fax | 360-326-9691
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Provider Business Mailing Address
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Address Line | 1498 SE TECH CENTER PL STE 300
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City | VANCOUVER
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State | WA
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Zip | 98683-5509
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Country | US
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Telephone | 360-619-2226
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Fax | 360-326-9691
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Authorized Official
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Title or Position | CREDENTIALING & CONTRACTING SPECIAL
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Name | KIM WATKINS
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Credential |
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Telephone | 360-619-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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