Provider Demographics
NPI:1558088179
Name:CANTRELL COUNSELING INCORPORATED
Entity Type:Organization
Organization Name:CANTRELL COUNSELING INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:C
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-714-1525
Mailing Address - Street 1:1050 LARRABEE AVE PMB 714
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7367
Mailing Address - Country:US
Mailing Address - Phone:360-714-1525
Mailing Address - Fax:360-935-2288
Practice Address - Street 1:1050 LARRABEE AVE STE 104
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7367
Practice Address - Country:US
Practice Address - Phone:360-714-1525
Practice Address - Fax:360-935-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty