Provider Demographics
NPI:1366792582
Name:SURINDER ANTAL COUNSELING SERVICES
Entity type:Organization
Organization Name:SURINDER ANTAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTAL
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:SURINDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:425-502-1329
Mailing Address - Street 1:1601 116TH AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3010
Mailing Address - Country:US
Mailing Address - Phone:425-502-1329
Mailing Address - Fax:
Practice Address - Street 1:1601 116TH AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:425-502-1329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH0010400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0007415843OtherAETNA
WAA00BCM100000OtherBLUE CROSS