Provider Demographics
NPI:1043810633
Name:SENIOR BEHAVIORAL HEALTH SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:SENIOR BEHAVIORAL HEALTH SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BERRY-REICH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-535-3847
Mailing Address - Street 1:PO BOX 2164
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0480
Mailing Address - Country:US
Mailing Address - Phone:206-387-2469
Mailing Address - Fax:877-682-9319
Practice Address - Street 1:4445 SE FIRMONT DR
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-9015
Practice Address - Country:US
Practice Address - Phone:360-535-3847
Practice Address - Fax:877-682-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-01
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty