Provider Demographics
NPI:1316391626
Name:RECAPTURING DREAMS COUNSELING
Entity Type:Organization
Organization Name:RECAPTURING DREAMS COUNSELING
Other - Org Name:HEALING HEARTS AFFIRMATION CENTER FOR AT-RISK FAMILIES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:CORDEALIA
Authorized Official - Middle Name:CORY
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS
Authorized Official - Phone:360-373-0332
Mailing Address - Street 1:865 6TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-1495
Mailing Address - Country:US
Mailing Address - Phone:360-373-0332
Mailing Address - Fax:
Practice Address - Street 1:3320 NARROWS VIEW LN NE UNIT 102
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2270
Practice Address - Country:US
Practice Address - Phone:253-348-8886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251S0000X-251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health