Provider Demographics
NPI:1356744460
Name:IBG COUNSELING AND EDUCATIONAL CENTER, INC
Entity type:Organization
Organization Name:IBG COUNSELING AND EDUCATIONAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELITA
Authorized Official - Middle Name:HANNAH
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:253-970-6499
Mailing Address - Street 1:10202 PACIFIC AVE S STE 208
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6573
Mailing Address - Country:US
Mailing Address - Phone:253-970-6499
Mailing Address - Fax:253-581-0927
Practice Address - Street 1:10202 PACIFIC AVE S STE 208
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6573
Practice Address - Country:US
Practice Address - Phone:253-970-6499
Practice Address - Fax:253-581-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602485247251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management