Provider Demographics
NPI:1659827046
Name:PEPPERMINTZ CONSULTING
Entity Type:Organization
Organization Name:PEPPERMINTZ CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSLYN
Authorized Official - Middle Name:CYNKUS
Authorized Official - Last Name:MINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:206-946-1685
Mailing Address - Street 1:3614 CALIFORNIA AVE SW # 214
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3780
Mailing Address - Country:US
Mailing Address - Phone:206-946-1685
Mailing Address - Fax:
Practice Address - Street 1:3614 CALIFORNIA AVE SW # 214
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3780
Practice Address - Country:US
Practice Address - Phone:206-946-1685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty