Provider Demographics
NPI:1396795332
Name:DOLORES AND CHARLES, INC
Entity type:Organization
Organization Name:DOLORES AND CHARLES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CDP
Authorized Official - Phone:425-347-9070
Mailing Address - Street 1:7207 EVERGREEN WAY
Mailing Address - Street 2:SUITE M
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-5678
Mailing Address - Country:US
Mailing Address - Phone:425-347-9070
Mailing Address - Fax:425-348-3676
Practice Address - Street 1:7207 EVERGREEN WAY
Practice Address - Street 2:SUITE M
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5678
Practice Address - Country:US
Practice Address - Phone:425-347-9070
Practice Address - Fax:425-348-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00002740101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty