Provider Demographics
NPI:1740727494
Name:MCS COUNSELING GROUP LLC
Entity type:Organization
Organization Name:MCS COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTERBURY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-698-5883
Mailing Address - Street 1:3888 NW RANDALL WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7847
Mailing Address - Country:US
Mailing Address - Phone:360-698-5883
Mailing Address - Fax:360-809-6002
Practice Address - Street 1:3888 NW RANDALL WAY STE 201
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7847
Practice Address - Country:US
Practice Address - Phone:360-698-5883
Practice Address - Fax:360-809-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2080351Medicaid