Provider Demographics
NPI:1023562170
Name:KASSUHN INC DBA ALTERNATIVE COUNSELING
Entity Type:Organization
Organization Name:KASSUHN INC DBA ALTERNATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KASSUHN
Authorized Official - Suffix:
Authorized Official - Credentials:CDP, DVC
Authorized Official - Phone:253-538-2323
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-0685
Mailing Address - Country:US
Mailing Address - Phone:253-538-2323
Mailing Address - Fax:
Practice Address - Street 1:17002 PACIFIC AVE S
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8253
Practice Address - Country:US
Practice Address - Phone:253-538-2323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60237827252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency