Provider Demographics
NPI:1790326734
Name:WALK IN HOPE COUNSELING PLLC
Entity Type:Organization
Organization Name:WALK IN HOPE COUNSELING PLLC
Other - Org Name:WALK IN HOPE 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:A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-726-4626
Mailing Address - Street 1:13204 NE 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-4927
Mailing Address - Country:US
Mailing Address - Phone:719-291-6544
Mailing Address - Fax:877-882-1326
Practice Address - Street 1:10000 NE 7TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4545
Practice Address - Country:US
Practice Address - Phone:360-726-4626
Practice Address - Fax:877-882-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2124302Medicaid