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General NPI Number Information
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NPI Number | 1386939593
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Entity Type | Organization
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Legal Business Name | CONSEJO COUNSELING AND REFERRAL SERVICE - KENT
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 515 W HARRISON ST STE 109
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City | KENT
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State | WA
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Zip | 98032-4403
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Country | US
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Telephone | 253-856-9000
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Fax | 253-520-6647
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Provider Business Mailing Address
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Address Line | 3808 S ANGELINE ST
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City | SEATTLE
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State | WA
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Zip | 98118-1712
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Country | US
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Telephone | 206-461-4880
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Fax | 206-461-6989
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARIO PAREDES
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Credential |
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Telephone | 206-461-4880
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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 |
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License Number State | WA
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