| Organization Name: | KEY PENINSULA COUNSELING CENTER |
| NPI Number: | 1073996278 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHAD HUNTER BEAVER (OWNER/THERAPIST) |
| Mailing Address: | 8903 Key Peninsula Hwy N Lakebay |
| State: | WA US |
| Postal Code: | 983499326 |
| Phone Number: | 2538843644 |
| Fax Number: | 2538842632 |
| NPI Enumeration Date: | 07/07/2015 |
| NPI Last Update Date: | 07/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH60544428 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |