Provider Demographics
NPI:1174305841
Name:PLAY BY PLAY COUNSELING
Entity type:Organization
Organization Name:PLAY BY PLAY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHILD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAECHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-904-2324
Mailing Address - Street 1:4405 7TH AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4405 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1062
Practice Address - Country:US
Practice Address - Phone:253-904-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty