Provider Demographics
NPI:1265858534
Name:CENTER FOR SYSTEMATIC THERAPY AND RESEARCH SERCIVES
Entity Type:Organization
Organization Name:CENTER FOR SYSTEMATIC THERAPY AND RESEARCH SERCIVES
Other - Org Name:CSTARS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-929-1543
Mailing Address - Street 1:402 S 333RD ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6309
Mailing Address - Country:US
Mailing Address - Phone:253-929-1543
Mailing Address - Fax:866-311-9279
Practice Address - Street 1:402 S 333RD ST
Practice Address - Street 2:SUITE 121
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6309
Practice Address - Country:US
Practice Address - Phone:253-929-1543
Practice Address - Fax:866-311-9279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60323507251S00000X
WAPY00002013251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health