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General NPI Number Information
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NPI Number | 1164296828
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Entity Type | Organization
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Legal Business Name | FLYING BAGEL COUNSELING SERVICES
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 509 4TH ST STE 7
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City | BREMERTON
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State | WA
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Zip | 98337-1401
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Country | US
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Telephone | 360-620-3402
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Fax |
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Provider Business Mailing Address
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Address Line | 509 4TH ST STE 7
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City | BREMERTON
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State | WA
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Zip | 98337-1401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MARY ROSE DEWALD
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Credential | LICSW
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Telephone | 360-990-3505
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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