Provider Demographics
NPI:1194557298
Name:TAKING FLIGHT MENTAL HEALTH
Entity type:Organization
Organization Name:TAKING FLIGHT MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMC
Authorized Official - Phone:425-977-3798
Mailing Address - Street 1:13322 HIGHWAY 99 STE 102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5440
Mailing Address - Country:US
Mailing Address - Phone:425-977-3798
Mailing Address - Fax:425-382-5099
Practice Address - Street 1:13322 HIGHWAY 99 STE 102
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5440
Practice Address - Country:US
Practice Address - Phone:425-977-3798
Practice Address - Fax:425-382-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty