Provider Demographics
NPI:1346898871
Name:LIFE AFFIRMING PSYCHOTHERAPY, PC
Entity Type:Organization
Organization Name:LIFE AFFIRMING PSYCHOTHERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-253-3641
Mailing Address - Street 1:108 SE 124TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684
Mailing Address - Country:US
Mailing Address - Phone:360-253-3641
Mailing Address - Fax:360-885-4944
Practice Address - Street 1:108 SE 124TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684
Practice Address - Country:US
Practice Address - Phone:360-253-3641
Practice Address - Fax:360-885-4944
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE AFFIRMING PSYCHOTHERAPY,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty