Provider Demographics
NPI:1295210896
Name:ANCHOR CHRISTIAN COUNSELING, LLC
Entity Type:Organization
Organization Name:ANCHOR CHRISTIAN COUNSELING, LLC
Other - Org Name:ANCHOR CHRISTIAN COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, MHP, CDP
Authorized Official - Phone:253-878-5816
Mailing Address - Street 1:33309 1ST WAY S STE 105
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6260
Mailing Address - Country:US
Mailing Address - Phone:253-878-5816
Mailing Address - Fax:253-878-5823
Practice Address - Street 1:33309 1ST WAY S STE 105
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6260
Practice Address - Country:US
Practice Address - Phone:253-878-5816
Practice Address - Fax:253-878-5823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1699119115OtherPERSONAL NPI
12541422OtherCAQH