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General NPI Number Information
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NPI Number | 1750823662
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Entity Type | Organization
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Legal Business Name | SEATTLE SOCIAL WORK AND COUNSELING
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 1812 E MADISON ST #202
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City | SEATTLE
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State | WA
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Zip | 98122-2843
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Country | US
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Telephone | 858-598-3713
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Fax |
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Provider Business Mailing Address
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Address Line | 7414 S 128TH ST
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City | SEATTLE
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State | WA
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Zip | 98178-4346
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Country | US
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Telephone | 858-598-3713
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER/COUNSELOR
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Name | JENNIFER WILDE
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Credential |
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Telephone | 858-598-3713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LW60543263
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LW60543263
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License Number State | WA
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