Provider Demographics
NPI:1144790858
Name:RESTORING CONNECTIONS COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:RESTORING CONNECTIONS COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIEB
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-399-6868
Mailing Address - Street 1:1155 N STATE ST STE 520
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5045
Mailing Address - Country:US
Mailing Address - Phone:360-399-6868
Mailing Address - Fax:
Practice Address - Street 1:1155 N STATE ST STE 520
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5045
Practice Address - Country:US
Practice Address - Phone:360-399-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty