Provider Demographics
NPI:1295052744
Name:HEALING CHANGE COUNSELING
Entity type:Organization
Organization Name:HEALING CHANGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:MCRUER-WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:425-283-7308
Mailing Address - Street 1:300 NE GILMAN BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2941
Mailing Address - Country:US
Mailing Address - Phone:425-283-7308
Mailing Address - Fax:
Practice Address - Street 1:300 NE GILMAN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2941
Practice Address - Country:US
Practice Address - Phone:425-283-7308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60089692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty