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General NPI Number Information
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NPI Number | 1265611552
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Entity Type | Organization
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Legal Business Name | COUNSELING SERVICES INC
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 7500 212TH ST SW SUITE 204
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City | EDMONDS
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State | WA
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Zip | 98026-7641
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Country | US
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Telephone | 425-774-5777
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 212TH ST SW SUITE 204
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City | EDMONDS
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State | WA
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Zip | 98026-7641
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Country | US
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Telephone | 425-774-5777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEN NICHOLS-HOPPE
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Credential | PH.D.
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Telephone | 425-774-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSYCH0001028
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | AP30001487
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSYCH0001028
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License Number State | WA
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