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Organization
PILGRIM BEHAVIORAL HEALTH
Active
Organization
PILGRIM BEHAVIORAL HEALTH
Active
Other names
Pilgrim Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY PILGRIM LICSW (OWNER, CLINICAL DIRECTOR)
(505) 501-8293
Entity
Organization
Contact information
Practice address
4405 7TH AVENUE STE 200, LACEY, WA 98503
(505) 501-8293
(505) 521-5149
Mailing address
46 VILLAGE WAY # 107, PORT LUDLOW, WA 98365-5102
(505) 501-8293
(505) 521-5149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007433
—
HI
05
—
1568137370
—
NM
05
—
44002335
—
NM
Enumeration date
08/13/2021
Last updated
07/23/2024
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