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General NPI Number Information
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NPI Number | 1477462075
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Entity Type | Organization
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Legal Business Name | SENDERO COUNSELING SERVICES
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 2142 W RAILROAD AVE
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City | SHELTON
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State | WA
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Zip | 98584-7813
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Country | US
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Telephone | 253-354-3764
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Fax | 253-354-7440
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Provider Business Mailing Address
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Address Line | 312 STELLA CT NW
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City | YELM
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State | WA
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Zip | 98597-6623
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Country | US
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Telephone | 253-354-3764
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Fax | 253-354-7440
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | WILFREDO FERNANDEZ-FONSECA
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Credential | LMHCA
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Telephone | 253-354-3764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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