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General NPI Number Information
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NPI Number | 1225262942
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Entity Type | Organization
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Legal Business Name | FOUR DIRECTIONS COUNSELING CENTER PC.
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 201 NE PARK PLAZA DR STE 215
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City | VANCOUVER
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State | WA
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Zip | 98684-5871
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Country | US
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Telephone | 360-882-3464
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Fax | 360-882-9190
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Provider Business Mailing Address
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Address Line | PO BOX 821906
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City | VANCOUVER
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State | WA
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Zip | 98682-0044
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Country | US
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Telephone | 360-884-3464
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Fax | 360-882-9190
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Authorized Official
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Title or Position | CFO
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Name | MS. CYNTHIA M OLIVIER
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Credential | LICSW
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Telephone | 360-882-3464
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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 | 601843447
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License Number State | WA
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