=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376296632
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SATORI COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2022
-----------------------------------------------------
Last Update Date | 12/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 518 S 7TH ST APT 216
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98402-2213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-209-5723
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 518 S 7TH ST APT 216
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98402-2213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-209-5723
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | JESSICA PATRICIA GONZALEZ
-----------------------------------------------------
Credential | LMHC LH61380444
-----------------------------------------------------
Telephone | 719-209-5723
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------