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General NPI Number Information
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NPI Number | 1811214893
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Entity Type | Organization
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Legal Business Name | CROSSPATH COUNSELING & CONSULTATION, LLC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 550 222ND PL SE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7111
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Country | US
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Telephone | 425-369-1111
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Fax | 425-369-1112
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Provider Business Mailing Address
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Address Line | 550 222ND PL SE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7111
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Country | US
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Telephone | 425-369-1111
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Fax | 425-369-1112
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. BELINDA LAFFERTY
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Credential | L.M.H.C.
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Telephone | 425-369-1111
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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 | LH60094600
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | MD00013428
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH00005878
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License Number State | WA
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