Provider Demographics
NPI:1043080807
Name:HALCYON COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:HALCYON COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVRISHOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-559-1468
Mailing Address - Street 1:10818 NE COXLEY DR STE O
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6163
Mailing Address - Country:US
Mailing Address - Phone:360-559-1468
Mailing Address - Fax:
Practice Address - Street 1:10818 NE COXLEY DR STE O
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6163
Practice Address - Country:US
Practice Address - Phone:360-559-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty