Provider Demographics
NPI:1740610526
Name:TALLISON GROUP, INC
Entity Type:Organization
Organization Name:TALLISON GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-779-2738
Mailing Address - Street 1:P.O. BOX 1818
Mailing Address - Street 2:9119 RIDGETOP BLVD, #220
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-779-2738
Mailing Address - Fax:360-697-5308
Practice Address - Street 1:9119 RIDGETOP BLVD
Practice Address - Street 2:SUITE #220
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383
Practice Address - Country:US
Practice Address - Phone:360-779-2738
Practice Address - Fax:360-697-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty