Organization
CATHOLIC COMMUNITY SERVICES WW
Active
Other names
CCSWW-FPS Olympia
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MARGUERITE THELEN (SYSTEM IMPLEMENTATION SPECIALIST)
(253) 759-9544
Entity
Organization
Contact information
Practice address
402 YAUGER WAY SW, OLYMPIA, WA 98502-8660
(360) 878-8248
Mailing address
1202 BLACK LAKE BLVD SW STE B, OLYMPIA, WA 98502-7208
(360) 878-8248
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
169
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169
COMMUNITY MENTAL HEALTH LICENSE
WA
Enumeration date
03/09/2010
Last updated
01/08/2024
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