Provider Demographics
NPI:1417134172
Name:CHARIS COUNSELING LLC
Entity Type:Organization
Organization Name:CHARIS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-312-4093
Mailing Address - Street 1:3025 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-9522
Mailing Address - Country:US
Mailing Address - Phone:360-595-6011
Mailing Address - Fax:
Practice Address - Street 1:1427 MONTE VISTA DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-9114
Practice Address - Country:US
Practice Address - Phone:360-312-4093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00023108OtherCOUNSELOR REGISTERED
WALH00011157OtherMENTAL HEALTH COUNSELOR