| Community Life Counseling Services | |
|
612 113th St S Tacoma WA 98444-4902 | |
| (253) 301-8140 | |
| Not Available |
| Full Name | Community Life Counseling Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 612 113th St S, Tacoma, Washington |
| Authorized Official Name and Position | Emmanuel Villarivera (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2533018140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Life Counseling Services 4815 51st Avenue Ct W University Place WA 98467-4827 Ph: () - | Community Life Counseling Services 612 113th St S Tacoma WA 98444-4902 Ph: (253) 301-8140 |
| NPI Number | 1578158077 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 03/05/2021 |
| Certification Date | 03/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578158077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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