=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306715701
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPIRITUAL EMERGENCE COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2025
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 727 N 182ND ST STE 202
-----------------------------------------------------
City | SHORELINE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-369-1211
-----------------------------------------------------
Fax | 206-542-5235
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 125 N 105TH ST
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-8701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-369-1211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | MR. KEVIN P MALOY
-----------------------------------------------------
Credential | LMHC, ACS
-----------------------------------------------------
Telephone | 206-369-1211
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------