Provider Demographics
NPI:1659879690
Name:MOLLESTON LUKE COUNSELING
Entity Type:Organization
Organization Name:MOLLESTON LUKE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:MOLLESTON LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:253-224-3432
Mailing Address - Street 1:1002 N MERIDIAN STE 100-197
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-4409
Mailing Address - Country:US
Mailing Address - Phone:253-224-3432
Mailing Address - Fax:253-251-0640
Practice Address - Street 1:437 29TH ST NE STE F
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6784
Practice Address - Country:US
Practice Address - Phone:253-330-7204
Practice Address - Fax:253-251-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty