Provider Demographics
NPI:1861663684
Name:CENTER FOR COUNSELING & PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:CENTER FOR COUNSELING & PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOLLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-966-7246
Mailing Address - Street 1:1015 S. 40TH AVENUE
Mailing Address - Street 2:SUITE 21-23
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3806
Mailing Address - Country:US
Mailing Address - Phone:509-966-7246
Mailing Address - Fax:509-966-5731
Practice Address - Street 1:1015 S. 40TH AVENUE
Practice Address - Street 2:SUITE 21-23
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3806
Practice Address - Country:US
Practice Address - Phone:509-966-7246
Practice Address - Fax:509-966-5731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601922782101Y00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty