Organization
FAMILY EDUCATION AND SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY R WILLIS (EXECTUIVE DIRECTOR)
(360) 754-7629
Entity
Organization
Contact information
Practice address
6840 CAPITOL BLVD SE BLDG 3, TUMWATER, WA 98501-5513
(360) 754-7629
(360) 705-3411
Mailing address
PO BOX 14907, TUMWATER, WA 98511-4907
(360) 754-7629
(360) 704-3411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
225C00000X
Rehabilitation Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
11/18/2019
Last updated
02/08/2021
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