Provider Demographics
NPI:1699256933
Name:REACH BEYOND COUNSELING AND COACHING SERVICES PLLC
Entity type:Organization
Organization Name:REACH BEYOND COUNSELING AND COACHING SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENISE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAGBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, SUDP,DVIT
Authorized Official - Phone:206-679-8291
Mailing Address - Street 1:15 S GRADY WAY STE 245
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3209
Mailing Address - Country:US
Mailing Address - Phone:206-679-8291
Mailing Address - Fax:206-274-6252
Practice Address - Street 1:15 S GRADY WAY STE 634
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3218
Practice Address - Country:US
Practice Address - Phone:206-679-8291
Practice Address - Fax:206-274-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60844525261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)