Heavensfield Group, Llc | |
1001 290th Ave Se Fall City WA 98024-7403 | |
(425) 222-3706 | |
(888) 788-3419 |
Full Name | Heavensfield Group, Llc |
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Speciality | Social Worker - Clinical |
Location | 1001 290th Ave Se, Fall City, Washington |
Authorized Official Name and Position | Cosette D Rae (CLINICAL DIRECTOR) |
Authorized Official Contact | 4254170406 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Heavensfield Group, Llc 1001 290th Ave Se Fall City WA 98024-7403 Ph: (425) 222-3706 | Heavensfield Group, Llc 1001 290th Ave Se Fall City WA 98024-7403 Ph: (425) 222-3706 |
NPI Number | 1194092130 |
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Provider Enumeration Date | 11/18/2011 |
Last Update Date | 11/18/2011 |
Identifier | Type | State | Issuer |
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1194092130 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LH00003472 (Washington) | Secondary |
1041C0700X | Social Worker - Clinical | SC60106047 (Washington) | Primary |