Provider Demographics
NPI:1811304025
Name:SOUND FAMILY CENTER, LLC
Entity type:Organization
Organization Name:SOUND FAMILY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAELI
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:206-419-9168
Mailing Address - Street 1:17924 140TH AVE NE
Mailing Address - Street 2:STE #230
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:UM
Mailing Address - Phone:206-419-9168
Mailing Address - Fax:206-555-5555
Practice Address - Street 1:17924 140TH AVE NE
Practice Address - Street 2:STE#230
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4315
Practice Address - Country:US
Practice Address - Phone:206-419-9168
Practice Address - Fax:206-555-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60295090101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty