Provider Demographics
NPI:1801938204
Name:M SUSAN HASKINS PS INC
Entity type:Organization
Organization Name:M SUSAN HASKINS PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:M
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMHC
Authorized Official - Phone:360-676-1513
Mailing Address - Street 1:1210 10TH ST
Mailing Address - Street 2:#203
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-676-1513
Mailing Address - Fax:360-647-1043
Practice Address - Street 1:1210 10TH ST
Practice Address - Street 2:#203
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-676-1513
Practice Address - Fax:360-647-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA020703LH00004072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005557755OtherAETNA
37687OtherRIDER # REGENCE BCBS
WA8917831OtherCRIME VICTIMS COMP