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General NPI Number Information
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NPI Number | 1154031128
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Entity Type | Organization
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Legal Business Name | MASTERPEACE COUNSELING, PLLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1311 E DIVISION ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4134
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Country | US
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Telephone | 360-300-5755
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Fax | 360-276-6450
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Provider Business Mailing Address
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Address Line | PO BOX 257 PMB 9911
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City | OLYMPIA
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State | WA
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Zip | 98507
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Country | US
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Telephone | 360-300-5755
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Fax | 360-276-6450
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINE CRUSE
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Credential | MSW, LICSW, CMHS
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Telephone | 360-300-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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