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General NPI Number Information
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NPI Number | 1750995072
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Entity Type | Organization
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Legal Business Name | ASCENSION BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 350 SE ANDREWS ST
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City | ISSAQUAH
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State | WA
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Zip | 98027-3413
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Country | US
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Telephone | 248-412-3964
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Fax |
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Provider Business Mailing Address
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Address Line | 1567 HIGHLANDS DR NE STE 110
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City | ISSAQUAH
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State | WA
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Zip | 98029-6256
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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 | OWNER
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Name | CHRISTEN ANN RAE
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Credential | M.A., BCBA, LBA
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Telephone | 248-412-3964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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