| Center For Counseling & Psychotherapy Llc | |
|
1015 S. 40th Avenue Suite 21-23 Yakima WA 98908-3806 | |
| (509) 966-7246 | |
| (509) 966-5731 |
| Full Name | Center For Counseling & Psychotherapy Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1015 S. 40th Avenue, Yakima, Washington |
| Authorized Official Name and Position | Duane T Dolliver (OWNER) |
| Authorized Official Contact | 5099667246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Counseling & Psychotherapy Llc 1015 S. 40th Avenue Suite 21-23 Yakima WA 98908-3806 Ph: (509) 966-7246 | Center For Counseling & Psychotherapy Llc 1015 S. 40th Avenue Suite 21-23 Yakima WA 98908-3806 Ph: (509) 966-7246 |
| NPI Number | 1861663684 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 10/04/2021 |
| Certification Date | 10/04/2021 |
| Medicare PECOS PAC ID | 1052471240 |
|---|---|
| Medicare Enrollment ID | O20081118000385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861663684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 601922782 (Washington) | Secondary |
| 103TC1900X | Psychologist - Counseling | 601922782 (Washington) | Primary |
| Provider Name | Carly A Mankus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770863987 PECOS PAC ID: 8820328073 Enrollment ID: I20191001002115 |
| Provider Name | Duane Dolliver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518043900 PECOS PAC ID: 7113087305 Enrollment ID: I20240203000409 |
| Provider Name | Taylor E Klein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679956254 PECOS PAC ID: 5092111864 Enrollment ID: I20240323000116 |
| Provider Name | Crystal M Tyree |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609231323 PECOS PAC ID: 6608315635 Enrollment ID: I20240822001135 |
| Provider Name | Jeffery D Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376873489 PECOS PAC ID: 9537599238 Enrollment ID: I20240829004080 |
| Provider Name | Esther Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932336336 PECOS PAC ID: 6103359252 Enrollment ID: I20241028001822 |
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