Provider Demographics
NPI:1679750921
Name:INTEGRATIVE COUNSELING SERVICES
Entity Type:Organization
Organization Name:INTEGRATIVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:REDING
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CDP, LMHC
Authorized Official - Phone:206-216-5000
Mailing Address - Street 1:3518 FREMONT AVE N
Mailing Address - Street 2:SUITE 258
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8814
Mailing Address - Country:US
Mailing Address - Phone:206-216-5000
Mailing Address - Fax:206-216-5002
Practice Address - Street 1:701 N 36TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8868
Practice Address - Country:US
Practice Address - Phone:206-216-5000
Practice Address - Fax:206-216-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17136000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1060495Medicaid