Provider Demographics
NPI:1912160466
Name:HUMAN DEVELOPMENT & STRESS MANAGEMENT CENTER, LLC
Entity Type:Organization
Organization Name:HUMAN DEVELOPMENT & STRESS MANAGEMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:360-377-9032
Mailing Address - Street 1:PO BOX 563
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-0111
Mailing Address - Country:US
Mailing Address - Phone:360-377-9032
Mailing Address - Fax:360-377-0129
Practice Address - Street 1:1007 SCOTT AVE STE F
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4874
Practice Address - Country:US
Practice Address - Phone:360-377-9032
Practice Address - Fax:360-377-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-04
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center