Provider Demographics
NPI:1265681027
Name:SOUND YOUTH COUNSELING
Entity Type:Organization
Organization Name:SOUND YOUTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-627-4264
Mailing Address - Street 1:717 TACOMA AVE S
Mailing Address - Street 2:SUITE C
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2201
Mailing Address - Country:US
Mailing Address - Phone:253-627-4264
Mailing Address - Fax:253-779-0595
Practice Address - Street 1:717 TACOMA AVE S
Practice Address - Street 2:SUITE C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-2201
Practice Address - Country:US
Practice Address - Phone:253-627-4264
Practice Address - Fax:253-779-0595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601717936251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health