Counseling Services of Walla Walla

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

LW00006668 Issued in WA

Legal business name

COUNSELING SERVICES OF WALLA WALLA

Practice address

127 E Rose St
Suite M
Walla Walla, WA 99362-5009

Phone

(509) 876-0100

Fax

(509) 876-0101

NPI assigned

Feb 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marti K Bradley, MSW ACSW LICSW

Title

Owner

Phone

(509) 876-0100

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1114386711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3324",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620367",
            "telephone_number": "509-876-0100",
            "fax_number": "509-876-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E ROSE ST",
            "address_2": "SUITE M",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993625009",
            "telephone_number": "509-876-0100",
            "fax_number": "509-876-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING SERVICES OF WALLA WALLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MARTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-876-0100",
        "authorized_official_credential": "MSW ACSW LICSW"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "LW00006668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "1041C0700X",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW LICENSE",
            "identifier": "LW00006668",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "603-575-701",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Todd Cornia, DPM
• Itsel Corona Madrigal
• Elizabeth Corrales
• Jeffery Michael Cortez, PHARMD, MBA
• Marissa Lynn Cosaert
• County of Walla Walla
• County of Walla Walla
• County of Walla Walla
• County of Walla Walla
• Jennie L. Courtney, R.N.

• Point of Service in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Point of Service in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.