Provider Demographics
NPI:1942439732
Name:AWCODATE, INC.
Entity Type:Organization
Organization Name:AWCODATE, INC.
Other - Org Name:AWARENESS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TEWAULT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:360-330-2832
Mailing Address - Street 1:107 N TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-4253
Mailing Address - Country:US
Mailing Address - Phone:360-330-2832
Mailing Address - Fax:360-330-0284
Practice Address - Street 1:107 N TOWER AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4253
Practice Address - Country:US
Practice Address - Phone:360-330-2832
Practice Address - Fax:360-330-0284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty