Baci Counseling, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

BACI COUNSELING, LLC

Practice address

3707 Smithers Ave S
Renton, WA 98055-6808

Phone

(206) 356-2640

Fax

(425) 955-9326

NPI assigned

May 9, 2019

Last updated

May 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Phoukham Kelly Bounkeua, PHD

Title

Director/Owner

Phone

(206) 345-2640

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1356906853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 SMITHERS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556808",
            "telephone_number": "206-356-2640",
            "fax_number": "425-955-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 SMITHERS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556808",
            "telephone_number": "206-356-2640",
            "fax_number": "425-955-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACI COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "BOUNKEUA",
        "authorized_official_first_name": "PHOUKHAM",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "206-345-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Renton, WA
• Providers in Renton, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.