Provider Demographics
NPI:1164077582
Name:WATERTON COUNSELING PLLC
Entity Type:Organization
Organization Name:WATERTON COUNSELING PLLC
Other - Org Name:WATERTON COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:KANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-770-2955
Mailing Address - Street 1:13303 NE 175TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17220 127TH PL NE STE 101C
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7965
Practice Address - Country:US
Practice Address - Phone:425-298-5543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty