Organization Name: | THERAPEUTIC SUPPORT SERVICES INC |
NPI Number: | 1316238678 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEREK ALAN CRAIN (OWNER) |
Mailing Address: | 21907 64th Ave W Ste 200 Mountlake Terrace |
State: | WA US |
Postal Code: | 980436200 |
Phone Number: | 4256407009 |
Fax Number: | 4256409600 |
NPI Enumeration Date: | 04/21/2011 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH 00006954 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |