Provider Demographics
NPI:1700240322
Name:CRISSEY BEHAVIORAL CONSULTING
Entity type:Organization
Organization Name:CRISSEY BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-601-6237
Mailing Address - Street 1:9265 44TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2624
Mailing Address - Country:US
Mailing Address - Phone:206-601-6237
Mailing Address - Fax:
Practice Address - Street 1:9265 44TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-2624
Practice Address - Country:US
Practice Address - Phone:206-601-6237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-12-11618103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty