Provider Demographics
NPI:1932748795
Name:VISAYA COUNSELING SERVICES P.L.L.C.
Entity Type:Organization
Organization Name:VISAYA COUNSELING SERVICES P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:509-952-7013
Mailing Address - Street 1:6108 BULLDOG LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3000
Mailing Address - Country:US
Mailing Address - Phone:509-952-7013
Mailing Address - Fax:
Practice Address - Street 1:3311 W CLEARWATER AVE STE D272
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2710
Practice Address - Country:US
Practice Address - Phone:509-952-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty