Provider Demographics
NPI:1235374737
Name:AL'TA COUNSELING
Entity Type:Organization
Organization Name:AL'TA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CDP
Authorized Official - Phone:253-273-8598
Mailing Address - Street 1:426 S 54TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-6551
Mailing Address - Country:US
Mailing Address - Phone:253-473-7586
Mailing Address - Fax:253-590-0224
Practice Address - Street 1:5435 SOUTH 'M' STREET, #103
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-3530
Practice Address - Country:US
Practice Address - Phone:253-473-7586
Practice Address - Fax:253-590-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602883324261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder