Provider Demographics
NPI:1689426645
Name:ALPINE CHRISTIAN COUNSELING LLC
Entity Type:Organization
Organization Name:ALPINE CHRISTIAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-332-1113
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:HUSUM
Mailing Address - State:WA
Mailing Address - Zip Code:98623-0188
Mailing Address - Country:US
Mailing Address - Phone:253-332-1113
Mailing Address - Fax:
Practice Address - Street 1:107 W JEWETT BLVD STE 700
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8974
Practice Address - Country:US
Practice Address - Phone:253-332-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty