Provider Demographics
NPI:1831129733
Name:K-J COUNSELING RESOURCES, INC.
Entity type:Organization
Organization Name:K-J COUNSELING RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAE-JE'
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PSYCHOLOGIST
Authorized Official - Phone:509-582-3766
Mailing Address - Street 1:506 E 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-5822
Mailing Address - Country:US
Mailing Address - Phone:509-582-3766
Mailing Address - Fax:
Practice Address - Street 1:506 E 44TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-5822
Practice Address - Country:US
Practice Address - Phone:509-582-3766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002470103T00000X, 103TC0700X, 103TC1900X
WARN00152836163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8411472Medicaid
WA8853361Medicare ID - Type Unspecified