Organization
HEAVENSFIELD GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COSETTE D RAE MSW, LSWAIC (CLINICAL DIRECTOR)
(425) 417-0406
Entity
Organization
Contact information
Practice address
1001 290TH AVE SE, FALL CITY, WA 98024-7403
(425) 222-3706
(888) 788-3419
Mailing address
1001 290TH AVE SE, FALL CITY, WA 98024-7403
(425) 222-3706
(888) 788-3419
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH00003472
WA
1041C0700X
Clinical Social Worker
Primary
SC60106047
WA
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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