Provider Demographics
NPI:1528315033
Name:SOUTH SOUND COUNSELING & CONSULTATION
Entity type:Organization
Organization Name:SOUTH SOUND COUNSELING & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:253-839-4172
Mailing Address - Street 1:31919 1ST AVE S
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5236
Mailing Address - Country:US
Mailing Address - Phone:253-839-4172
Mailing Address - Fax:484-924-3832
Practice Address - Street 1:31919 1ST AVE S
Practice Address - Street 2:SUITE 203
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5236
Practice Address - Country:US
Practice Address - Phone:253-839-4172
Practice Address - Fax:484-924-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60279408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1316241359OtherNPI
WA1902135981OtherNPI
WA320174475OtherNPI