Provider Demographics
NPI:1366156978
Name:AXEL THERAPY PLLC
Entity type:Organization
Organization Name:AXEL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:AXEL
Authorized Official - Last Name:STANOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:425-280-1172
Mailing Address - Street 1:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:WA
Mailing Address - Zip Code:98342-0536
Mailing Address - Country:US
Mailing Address - Phone:206-659-9333
Mailing Address - Fax:
Practice Address - Street 1:20534 FERN ST NE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:WA
Practice Address - Zip Code:98342-9007
Practice Address - Country:US
Practice Address - Phone:206-659-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty