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General NPI Number Information
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NPI Number | 1447510631
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Entity Type | Organization
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Legal Business Name | BERGMAN & FAUST COUNSELING, LLC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 3400 HARBOR AVE SW SUITE 301
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City | SEATTLE
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State | WA
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Zip | 98126-2394
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Country | US
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Telephone | 206-478-0315
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Fax |
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Provider Business Mailing Address
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Address Line | 830 S ORCAS ST
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City | SEATTLE
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State | WA
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Zip | 98108-2628
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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 | REGISTERED AGENT
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Name | JOHN FAUST
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Credential | LMHC, CDC1
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Telephone | 206-767-8076
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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 | 60261534
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License Number State | WA
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