Organization
COMMUNITY PSYCHIATRIC CLINIC INC
Active
Organization
COMMUNITY PSYCHIATRIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KELCEY SYMONS (ADMIN SUPERVISOR)
(206) 545-2387
Entity
Organization
Contact information
Practice address
11000 LAKE CITY WAY NE, SUITE 200, SEATTLE, WA 98125-6748
(206) 461-3614
(206) 634-0094
Mailing address
11000 LAKE CITY WAY NE, SUITE 200, SEATTLE, WA 98125-6748
(206) 461-3614
(206) 634-0094
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
117700
WA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
035
WA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
17087500
WA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
17087600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1981802
—
WA
05
—
1992650
—
WA
05
—
1992668
—
WA
05
—
1992874
—
WA
05
—
1992882
—
WA
05
—
1992890
—
WA
Enumeration date
01/17/2007
Last updated
09/26/2018
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