Provider Demographics
NPI:1114651130
Name:MARIPOSA COUNSELING PLLC
Entity Type:Organization
Organization Name:MARIPOSA COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:RILEY
Authorized Official - Last Name:FARAM
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:425-364-9796
Mailing Address - Street 1:19125 N CREEK PKWY STE 149
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8018
Mailing Address - Country:US
Mailing Address - Phone:425-364-9796
Mailing Address - Fax:
Practice Address - Street 1:19125 N CREEK PKWY STE 149
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8018
Practice Address - Country:US
Practice Address - Phone:425-364-9796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1235566886Medicaid