Provider Demographics
NPI:1073639753
Name:CASTEELE, WILLIAMS & ASSOCIATES COUNSELING AGENCY INC
Entity Type:Organization
Organization Name:CASTEELE, WILLIAMS & ASSOCIATES COUNSELING AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASTEELE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:253-536-2881
Mailing Address - Street 1:8833 PACIFIC AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6490
Mailing Address - Country:US
Mailing Address - Phone:253-536-2881
Mailing Address - Fax:253-536-2956
Practice Address - Street 1:8833 PACIFIC AVE STE D
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6490
Practice Address - Country:US
Practice Address - Phone:253-536-2881
Practice Address - Fax:253-536-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001490261QM0850X, 261QM0855X
WACP00002471324500000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children