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General NPI Number Information
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NPI Number | 1437017019
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Entity Type | Organization
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Legal Business Name | MT ADAMS BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 432 NE TOHOMISH ST
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City | WHITE SALMON
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State | WA
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Zip | 98672-1940
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Country | US
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Telephone | 215-264-0497
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 156
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City | TROUT LAKE
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State | WA
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Zip | 98650-0156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KATHERINE COUSINEAU
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Credential | PA-C
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Telephone | 215-264-0497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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