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Organization
LAKEWOOD CHILD AND FAMILY COUNSELING LLC
Active
Organization
LAKEWOOD CHILD AND FAMILY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE L KLEKOTA-CHISHOLM MA, LMHC (THERAPIST, OWNER)
(253) 617-3559
Entity
Organization
Contact information
Practice address
9311 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-1570
(253) 617-3559
(253) 486-1916
Mailing address
5409 100TH ST SW UNIT 98765, LAKEWOOD, WA 98496-0836
(253) 617-3559
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LH 60231172
WA
101YM0800X
Mental Health Counselor
Primary
LH 60231172
WA
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/28/2009
Last updated
07/02/2021
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