Provider Demographics
NPI:1780124107
Name:UPSIDE COUNSELING, PLLC
Entity type:Organization
Organization Name:UPSIDE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-335-2412
Mailing Address - Street 1:33919 9TH AVE S STE 203
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6736
Mailing Address - Country:US
Mailing Address - Phone:253-335-2412
Mailing Address - Fax:253-874-4733
Practice Address - Street 1:33919 9TH AVE S STE 203
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6736
Practice Address - Country:US
Practice Address - Phone:253-335-2412
Practice Address - Fax:253-874-4733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-04
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000082681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty