Provider Demographics
NPI:1376174037
Name:COURAGEOUS COUNSELING AND WELLNESS PLLC
Entity Type:Organization
Organization Name:COURAGEOUS COUNSELING AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:OZMENT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-332-9188
Mailing Address - Street 1:103 E 3RD ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1348
Mailing Address - Country:US
Mailing Address - Phone:360-253-9188
Mailing Address - Fax:
Practice Address - Street 1:103 E 3RD ST STE 203
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1348
Practice Address - Country:US
Practice Address - Phone:360-253-9188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty