Provider Demographics
NPI:1831888775
Name:BRANCHING OUT WELLBEING, LLC
Entity type:Organization
Organization Name:BRANCHING OUT WELLBEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER; LMHC
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAYSON
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LH61391989
Authorized Official - Phone:425-923-7640
Mailing Address - Street 1:19011 68TH AVE S STE A109
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-2108
Mailing Address - Country:US
Mailing Address - Phone:206-603-5411
Mailing Address - Fax:
Practice Address - Street 1:19011 68TH AVE S STE A109
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2108
Practice Address - Country:US
Practice Address - Phone:206-603-5411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty