Provider Demographics
NPI:1396941944
Name:FAMILY LIFE SKILLS OF WASHINGTON
Entity type:Organization
Organization Name:FAMILY LIFE SKILLS OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHAUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-352-4960
Mailing Address - Street 1:677 WOODLAND SQUARE LOOP SE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:677 WOODLAND SQUARE LOOP SE
Practice Address - Street 2:SUITE D
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1000
Practice Address - Country:US
Practice Address - Phone:360-352-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00040085101YM0800X
WARC00054684101YP1600X
WARC00040035101YP2500X
WARC00054687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty