Provider Demographics
NPI:1972085835
Name:PENINSULA COUNSELING, LLC
Entity type:Organization
Organization Name:PENINSULA COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPESI
Authorized Official - Suffix:
Authorized Official - Credentials:SUDP
Authorized Official - Phone:253-257-1770
Mailing Address - Street 1:3214 50TH ST CT NW STE 305
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8587
Mailing Address - Country:US
Mailing Address - Phone:253-257-1700
Mailing Address - Fax:253-257-1783
Practice Address - Street 1:3214 50TH ST CT NW STE 305
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8587
Practice Address - Country:US
Practice Address - Phone:253-257-1700
Practice Address - Fax:253-257-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 251S00000X
WA146100324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility