Provider Demographics
NPI:1134505407
Name:LEWIS COUNTY THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:LEWIS COUNTY THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:360-623-5008
Mailing Address - Street 1:715 H ST
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-4726
Mailing Address - Country:US
Mailing Address - Phone:360-623-5008
Mailing Address - Fax:
Practice Address - Street 1:1000 KRESKY AVE # 6
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3700
Practice Address - Country:US
Practice Address - Phone:360-623-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health