Provider Demographics
NPI:1629637103
Name:WHOLE VALLEY THERAPY, PLLC
Entity Type:Organization
Organization Name:WHOLE VALLEY THERAPY, PLLC
Other - Org Name:WHOLE VALLEY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:425-780-6227
Mailing Address - Street 1:PO BOX 816
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0816
Mailing Address - Country:US
Mailing Address - Phone:425-780-6227
Mailing Address - Fax:
Practice Address - Street 1:15315 1ST AVE NE STE 216
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5005
Practice Address - Country:US
Practice Address - Phone:206-612-3120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty