Provider Demographics
NPI:1194460055
Name:ALLUVIAL COUNSELING PLLP
Entity Type:Organization
Organization Name:ALLUVIAL COUNSELING PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROME
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:206-856-2791
Mailing Address - Street 1:316 MAIN ST STE B1
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:316 MAIN ST STE B1
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3197
Practice Address - Country:US
Practice Address - Phone:425-439-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty