| Lakewood Child And Family Counseling Llc | |
|
9311 Bridgeport Way Sw Lakewood WA 98499-1570 | |
| (253) 617-3559 | |
| (253) 486-1916 |
| Full Name | Lakewood Child And Family Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 9311 Bridgeport Way Sw, Lakewood, Washington |
| Authorized Official Name and Position | Michelle L Klekota-chisholm (THERAPIST, OWNER) |
| Authorized Official Contact | 2536173559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Child And Family Counseling Llc 5409 100th St Sw Unit 98765 Lakewood WA 98496-0836 Ph: (253) 617-3559 | Lakewood Child And Family Counseling Llc 9311 Bridgeport Way Sw Lakewood WA 98499-1570 Ph: (253) 617-3559 |
| NPI Number | 1952635716 |
|---|---|
| Provider Enumeration Date | 09/28/2009 |
| Last Update Date | 07/02/2021 |
| Certification Date | 07/02/2021 |
| Medicare PECOS PAC ID | 6800144346 |
|---|---|
| Medicare Enrollment ID | O20180731003223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952635716 | NPI | - | NPPES |
| Provider Name | Bonnie Margaret Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518347384 PECOS PAC ID: 4789934308 Enrollment ID: I20180831001804 |
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