1114354966 NPI number — ASPIRE BEHAVIORAL HEALTH COUNSELING SERVICES CO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114354966 NPI number — ASPIRE BEHAVIORAL HEALTH COUNSELING SERVICES CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRE BEHAVIORAL HEALTH COUNSELING SERVICES CO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114354966
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3205 NE 78TH ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98665-0697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-487-0856
Provider Business Mailing Address Fax Number:
877-281-1251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3205 NE 78TH ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98665-0697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-487-0856
Provider Business Practice Location Address Fax Number:
877-281-1251
Provider Enumeration Date:
10/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NEWTON
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
360-487-0856

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MG60279602 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: LH60507972 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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