MEDICARE: CONNECTED COUPLES COUNSELING PLLC

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	:	1851094213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED COUPLES COUNSELING PLLC

Provider Business Mailing Address
First Line	:	2855 SW 106TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-1200
Country	:	US
Telephone Number	:	317-902-6359
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 SW 106TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98146-1200
Country	:	US
Telephone Number	:	317-902-6359
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL D ELDER
Credential	:	LMHC, MA
Telephone Number	:	317-902-6359

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/24/2023

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