Provider Demographics
NPI:1659004844
Name:BIRCH HOLLOW THERAPY, PLLC
Entity Type:Organization
Organization Name:BIRCH HOLLOW THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-930-9434
Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19068 JENSEN WAY NE
Practice Address - Street 2:SUITE 7
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9837
Practice Address - Country:US
Practice Address - Phone:360-930-9434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health