Provider Demographics
NPI:1043067259
Name:THIN LINE COUNSELING & CONSULTING
Entity type:Organization
Organization Name:THIN LINE COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:GULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-554-2026
Mailing Address - Street 1:7021 KAU TRL
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9566
Mailing Address - Country:US
Mailing Address - Phone:509-554-2026
Mailing Address - Fax:
Practice Address - Street 1:5219 W CLEARWATER AVE STE 10A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1980
Practice Address - Country:US
Practice Address - Phone:509-221-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1023662590Medicaid