Provider Demographics
NPI:1932449287
Name:ISSAQUAH HIGHLANDS COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:ISSAQUAH HIGHLANDS COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:425-786-8566
Mailing Address - Street 1:22526 SE 64TH PL
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5368
Mailing Address - Country:US
Mailing Address - Phone:425-786-8566
Mailing Address - Fax:
Practice Address - Street 1:22526 SE 64TH PL
Practice Address - Street 2:SUITE 220
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5368
Practice Address - Country:US
Practice Address - Phone:425-786-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty