Provider Demographics
NPI:1568529543
Name:CONSEJO COUNSELING AND REFERRAL SERVICES
Entity Type:Organization
Organization Name:CONSEJO COUNSELING AND REFERRAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-802-1933
Mailing Address - Street 1:3808 S ANGELINE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1712
Mailing Address - Country:US
Mailing Address - Phone:206-461-4880
Mailing Address - Fax:206-461-6989
Practice Address - Street 1:3808 S ANGELINE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1712
Practice Address - Country:US
Practice Address - Phone:206-461-4880
Practice Address - Fax:206-461-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600287044251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0217936OtherL&I GROUP 82
WA24OtherWA STATE AGANCY
WA1992502Medicaid
WA1994755Medicaid
WA411OtherKC RSN
WA1995208Medicaid
WA7408578Medicaid
WA411OtherKC RSN