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NPI Code Detail

MEDICARE: TLC BEHAVIORAL CONSULTING

MEDICARE: TLC BEHAVIORAL CONSULTING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1538753454
Entity Type Code : Organization
Provider Name (Legal Business Name) : TLC BEHAVIORAL CONSULTING
Provider Business Mailing Address
First Line : 10411 NE FOURTH PLAIN BLVD STE 145
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-5755
Country : US
Telephone Number : 360-210-6168
Fax Number : 360-925-3183
Provider Business Practice Location Address
First Line : 10411 NE FOURTH PLAIN BLVD STE 145
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-5755
Country : US
Telephone Number : 360-210-6168
Fax Number : 360-925-3183
Authorized Official
Title or Position : FOUNDER
Name : CASSANDRA ANN WALLY
Credential : M.S
Telephone Number : 360-210-6168
Provider Enumeration Date : 02/22/2021
Last Update Date : 03/31/2026

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Directions to “TLC BEHAVIORAL CONSULTING ” Practice Location

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