Provider Demographics
NPI:1033570726
Name:KAYIJ-WINT COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:KAYIJ-WINT COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAJ
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:KAYIJ-WINT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:404-502-1236
Mailing Address - Street 1:1500 LAKE PARK DR SW APT 80
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-8116
Mailing Address - Country:US
Mailing Address - Phone:404-502-1236
Mailing Address - Fax:
Practice Address - Street 1:1500 LAKE PARK DR SW APT 80
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-8116
Practice Address - Country:US
Practice Address - Phone:404-502-1236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60465812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty