Provider Demographics
NPI:1922356906
Name:ACTION COUNSELING
Entity Type:Organization
Organization Name:ACTION COUNSELING
Other - Org Name:ROBERT LACK AND ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:LACK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CDP, CL
Authorized Official - Phone:509-735-7410
Mailing Address - Street 1:PO BOX 5697
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0697
Mailing Address - Country:US
Mailing Address - Phone:509-735-7410
Mailing Address - Fax:509-783-5953
Practice Address - Street 1:1010 E BRUNEAU AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3775
Practice Address - Country:US
Practice Address - Phone:509-735-7410
Practice Address - Fax:509-783-5953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACTION COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA03060500101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty