Provider Demographics
NPI:1225262942
Name:FOUR DIRECTIONS COUNSELING CENTER PC.
Entity Type:Organization
Organization Name:FOUR DIRECTIONS COUNSELING CENTER PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-882-3464
Mailing Address - Street 1:PO BOX 821906
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-0044
Mailing Address - Country:US
Mailing Address - Phone:360-884-3464
Mailing Address - Fax:360-882-9190
Practice Address - Street 1:201 NE PARK PLAZA DR STE 215
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5871
Practice Address - Country:US
Practice Address - Phone:360-882-3464
Practice Address - Fax:360-882-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601843447251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health