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General NPI Number Information
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NPI Number | 1326438441
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Entity Type | Organization
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Legal Business Name | VANCOUVER COUNSELING GROUP
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 1104 MAIN ST SUITE 300
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City | VANCOUVER
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State | WA
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Zip | 98660-2999
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Country | US
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Telephone | 360-718-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 MAIN ST SUITE 300
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City | VANCOUVER
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State | WA
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Zip | 98660-2999
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Country | US
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Telephone | 360-718-8030
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL D BUYS
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Credential | M.A. LMHC
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Telephone | 503-997-5136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH60154560
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License Number State | WA
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