Provider Demographics
NPI:1427596949
Name:CAROUSEL COUNSELING, PLLC
Entity Type:Organization
Organization Name:CAROUSEL COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, STAFF
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:253-332-1030
Mailing Address - Street 1:10116 36TH AVENUE CT SW
Mailing Address - Street 2:109
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4791
Mailing Address - Country:US
Mailing Address - Phone:253-332-1030
Mailing Address - Fax:
Practice Address - Street 1:10116 36TH AVENUE CT SW
Practice Address - Street 2:109
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4791
Practice Address - Country:US
Practice Address - Phone:253-332-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60071452251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2011491Medicaid