=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891150504
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADONAI COUNSELING & EMPLOYMENT INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2015
-----------------------------------------------------
Last Update Date | 05/08/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4104 SOUTH M STREET
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98418-3836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-777-1434
-----------------------------------------------------
Fax | 253-697-0015
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4104 S M ST
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98418-3836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-777-1434
-----------------------------------------------------
Fax | 253-697-0015
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ANA CATALINA PERERA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 253-777-1434
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 27 1011 00
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------