| Heavensfield Group, Llc | |
|
1001 290th Ave Se Fall City WA 98024-7403 | |
| (425) 222-3706 | |
| (888) 788-3419 |
| Full Name | Heavensfield Group, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1001 290th Ave Se, Fall City, Washington |
| Authorized Official Name and Position | Cosette D Rae (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4254170406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heavensfield Group, Llc 1001 290th Ave Se Fall City WA 98024-7403 Ph: (425) 222-3706 | Heavensfield Group, Llc 1001 290th Ave Se Fall City WA 98024-7403 Ph: (425) 222-3706 |
| NPI Number | 1194092130 |
|---|---|
| Provider Enumeration Date | 11/18/2011 |
| Last Update Date | 11/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194092130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LH00003472 (Washington) | Secondary |
| 1041C0700X | Social Worker - Clinical | SC60106047 (Washington) | Primary |