| Consejo Counseling And Referral Service - South Park | |
|
8615 14th Ave S Seattle WA 98108-4806 | |
| (206) 461-4880 | |
| (206) 762-0489 |
| Full Name | Consejo Counseling And Referral Service - South Park |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8615 14th Ave S, Seattle, Washington |
| Authorized Official Name and Position | Mario Paredes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2064614880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Consejo Counseling And Referral Service - South Park 3808 S Angeline St Seattle WA 98118-1712 Ph: (206) 461-4880 | Consejo Counseling And Referral Service - South Park 8615 14th Ave S Seattle WA 98108-4806 Ph: (206) 461-4880 |
| NPI Number | 1083771851 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 07/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083771851 | NPI | - | NPPES |
| 1994755 | Medicaid | WA | |
| 1995208 | Medicaid | WA | |
| 135400 | Other | WA | DBHR SITE LICENSE ID |
| 1992502 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 600287044 (Washington) | Secondary |
| 251S00000X | Community/behavioral Health | (Washington) | Primary |
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