Provider Demographics
NPI:1629759451
Name:DRAGO TREE COUNSELING, LLC
Entity Type:Organization
Organization Name:DRAGO TREE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MAMFT, LMHC
Authorized Official - Phone:360-524-1469
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0903
Mailing Address - Country:US
Mailing Address - Phone:360-524-1469
Mailing Address - Fax:
Practice Address - Street 1:1633 SW KELLY AVE
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3822
Practice Address - Country:US
Practice Address - Phone:360-524-1469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty