Provider Demographics
NPI:1609454537
Name:AZIMUTH COUNSELING PLLC
Entity Type:Organization
Organization Name:AZIMUTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:509-899-7685
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8392
Mailing Address - Country:US
Mailing Address - Phone:509-899-7685
Mailing Address - Fax:855-644-1338
Practice Address - Street 1:1206 N DOLARWAY RD STE 205
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8392
Practice Address - Country:US
Practice Address - Phone:509-899-7685
Practice Address - Fax:855-644-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2203415Medicaid