Provider Demographics
NPI:1023246667
Name:DOROTHY C. FLAHERTY, LLC
Entity type:Organization
Organization Name:DOROTHY C. FLAHERTY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:CHAFFEE
Authorized Official - Last Name:FLAHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-580-0748
Mailing Address - Street 1:10 PACIFIC LANE SOUTH
Mailing Address - Street 2:P.O. BOX 191
Mailing Address - City:PACIFIC BEACH
Mailing Address - State:WA
Mailing Address - Zip Code:98571
Mailing Address - Country:US
Mailing Address - Phone:360-580-0748
Mailing Address - Fax:
Practice Address - Street 1:10 PACIFIC LANE SOUTH
Practice Address - Street 2:
Practice Address - City:PACIFIC BEACH
Practice Address - State:WA
Practice Address - Zip Code:98571
Practice Address - Country:US
Practice Address - Phone:360-580-0748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60004868251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health