Organization
BEACH SIDE COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WINDY DREGA (CREDENTIALING, CONTRACTING, BILLING)
(360) 214-0749
Entity
Organization
Contact information
Practice address
811 PACIFIC AVE S STE 7, LONG BEACH, WA 98631-3544
(503) 440-3032
Mailing address
PO BOX 100, LONG BEACH, WA 98631-0100
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2139431
—
WA
Enumeration date
12/30/2019
Last updated
12/30/2019
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