Provider Demographics
NPI:1417091349
Name:COLUMBIA PSYCHOLOGICAL AND CONSULTING
Entity Type:Organization
Organization Name:COLUMBIA PSYCHOLOGICAL AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FLOHR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:360-772-7611
Mailing Address - Street 1:PO BOX 632
Mailing Address - Street 2:
Mailing Address - City:CATHLAMET
Mailing Address - State:WA
Mailing Address - Zip Code:98612-0632
Mailing Address - Country:US
Mailing Address - Phone:360-772-7611
Mailing Address - Fax:
Practice Address - Street 1:261 BEAVER CREEK RD
Practice Address - Street 2:
Practice Address - City:CATHLAMET
Practice Address - State:WA
Practice Address - Zip Code:98612
Practice Address - Country:US
Practice Address - Phone:360-772-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health