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General NPI Number Information
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NPI Number | 1932377637
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Entity Type | Organization
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Legal Business Name | BEACON COUPLE & FAMILY THERAPY
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 793 ERICKSEN AVE NE STE 123
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1877
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Country | US
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Telephone | 206-853-6852
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Fax |
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Provider Business Mailing Address
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Address Line | 793 ERICKSEN AVE NE STE 123
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1877
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Country | US
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Telephone | 206-853-6852
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Fax |
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Authorized Official
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Title or Position | COUPLE AND FAMILY THERAPIST
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Name | DR. ANGIE L. HOFFPAUIR
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Credential | PH.D.
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Telephone | 206-853-6852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW7685
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License Number State | WA
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