Provider Demographics
NPI:1598077232
Name:IT TAKES A VILLAGE PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:IT TAKES A VILLAGE PROFESSIONAL SERVICES
Other - Org Name:PATROCE BISHOP ENTERPRISES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:B ISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-838-3111
Mailing Address - Street 1:1707 S. 341ST PL #C
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003
Mailing Address - Country:US
Mailing Address - Phone:253-838-3111
Mailing Address - Fax:253-838-3674
Practice Address - Street 1:1707 S 341ST PL STE C
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6867
Practice Address - Country:US
Practice Address - Phone:253-838-3111
Practice Address - Fax:253-838-3674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IT TAKES A VILLAGE FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008156251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management