Organization
INTROSPECTIVE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNTI JOHNSON MSW, LSWAIC (MEMBER)
(916) 801-8351
Entity
Organization
Contact information
Practice address
6320 EVERGREEN WAY STE 213, EVERETT, WA 98203-4561
(916) 801-8351
Mailing address
6320 EVERGREEN WAY STE 213, EVERETT, WA 98203-4561
(916) 801-8351
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SC60527686
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SC60527686
LICENSED SOCIAL WORK ASSOCIATE INDEPENDENT CLINICAL
WA
Enumeration date
08/01/2017
Last updated
07/21/2022
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