MEDICARE: AEGIS COUNSELING SERVICES LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1578233813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEGIS COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	946 ROBERTS RD
Second Line	:
City	:	NEWPORT
State	:	WA
Zip	:	99156-5335
Country	:	US
Telephone Number	:	509-869-4578
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 W WALNUT ST STE 2
Second Line	:
City	:	NEWPORT
State	:	WA
Zip	:	99156-9388
Country	:	US
Telephone Number	:	509-869-4578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GRADY C HOAGLUND
Credential	:	PH.D
Telephone Number	:	509-869-4578

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	05/23/2023

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Directions to “AEGIS COUNSELING SERVICES LLC ” Practice Location

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