Provider Demographics
NPI:1598322109
Name:WINDS OF CHANGE COUNSELING, PLLC
Entity Type:Organization
Organization Name:WINDS OF CHANGE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW, LICSW
Authorized Official - Phone:206-856-7574
Mailing Address - Street 1:23830 PACIFIC HWY S
Mailing Address - Street 2:STE 202
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7706
Mailing Address - Country:US
Mailing Address - Phone:206-856-7574
Mailing Address - Fax:
Practice Address - Street 1:23830 PACIFIC HWY S
Practice Address - Street 2:STE 202
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-9803
Practice Address - Country:US
Practice Address - Phone:206-856-7574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)