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Organization

RESTART LIFE, PLLC

Active
Other names
Restart Internet Addiction Recovery
Organization subpart
No

Provider details

NPI number
Authorized official
COSETTE DAWNA RAE MSW (CEO)
(800) 682-6934
Entity
Organization

Contact information

Practice address
26509 NE VIRGINIA ST, DUVALL, WA 98019-6210
(800) 682-6934
(888) 788-3419
Mailing address
1001 290TH AVE SE, FALL CITY, WA 98024-7403
(800) 682-6934
(888) 788-3419

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
LH60152285
WA
101YM0800X
Mental Health Counselor
WA
1041C0700X
Clinical Social Worker
WA
163W00000X
Registered Nurse
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
320800000X
Mental Illness Community Based Residential Treatment Facility
323P00000X
Psychiatric Residential Treatment Facility
Primary

Other

Enumeration date
01/04/2012
Last updated
06/25/2025
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