Provider Demographics
NPI:1952911885
Name:ISAAC EKBLAD COUNSELING PLLC
Entity type:Organization
Organization Name:ISAAC EKBLAD COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:R
Authorized Official - Last Name:EKBLAD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:360-630-1663
Mailing Address - Street 1:127 ABBOTTS ALY
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-8826
Mailing Address - Country:US
Mailing Address - Phone:360-603-0339
Mailing Address - Fax:
Practice Address - Street 1:127 ABBOTTS ALY
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-8826
Practice Address - Country:US
Practice Address - Phone:360-603-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty