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General NPI Number Information
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NPI Number | 1427457621
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Entity Type | Organization
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Legal Business Name | LAKEWOOD COUNSELING SERVICES
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 5475 STEILACOOM BLVD SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-3122
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Country | US
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Telephone | 253-581-5656
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Fax | 253-650-2000
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Provider Business Mailing Address
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Address Line | 5475 STEILACOOM BLVD SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-3122
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Country | US
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Telephone | 253-581-5656
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Fax | 253-650-2000
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Authorized Official
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Title or Position | OWNER
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Name | JAMES WALTER WATT
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Credential | M.DIV
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Telephone | 253-581-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CL 60145803
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License Number State | WA
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