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General NPI Number Information
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NPI Number | 1942938634
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Entity Type | Organization
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Legal Business Name | MAGNOLIA COUNSELING SERVICES
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 14000 INTERURBAN AVE S
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City | TUKWILA
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State | WA
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Zip | 98168-4723
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Country | US
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Telephone | 206-693-9202
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Fax | 206-248-1160
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Provider Business Mailing Address
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Address Line | PO BOX 88732
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City | SEATTLE
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State | WA
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Zip | 98138-2732
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Country | US
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Telephone | 206-693-9202
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LANDER MITCHELL
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Credential |
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Telephone | 206-693-9202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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