Provider Demographics
NPI:1659890861
Name:PEAR TREE COUNSELING PLLC
Entity Type:Organization
Organization Name:PEAR TREE COUNSELING PLLC
Other - Org Name:PEAR TREE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DIAN
Authorized Official - Last Name:DISTEFANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-612-2396
Mailing Address - Street 1:108 SE 124TH AVE STE 22
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6015
Mailing Address - Country:US
Mailing Address - Phone:360-612-2396
Mailing Address - Fax:
Practice Address - Street 1:108 SE 124TH AVE STE 22
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6015
Practice Address - Country:US
Practice Address - Phone:360-612-2396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)