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Alex Lee Baccus
Peer Specialist in Centralia, Washington
NPI 1356062129

Alex Lee Baccus is a Peer Specialist based in Centralia, WA. Alex Lee Baccus practices in Centralia, WA. The NPI Number for Alex Lee Baccus is 1356062129 and holds a License No. (Washington).

The current practice location address for Alex Lee Baccus is 1707 Cooks Hill Rd, Centralia, WA and can be reached out via phone at 360-523-8396.

Location: 1707 Cooks Hill Rd, Centralia, WA, 98531-9071
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356062129
Provider Name
Alex Lee Baccus
Credential
Provider Entity Type
Individual
Gender
Female
Address
1707 Cooks Hill Rd, Centralia, WA, 98531-9071
Phone Number
360-523-8396
Fax Number
Provider Enumeration Date
09/08/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1707 Cooks Hill Rd
City
Centralia
State
Washington
Zip
98531-9071
Phone Number
360-523-8396
Fax Number
person
Provider Business Mailing Address Details
Address
1707 Cooks Hill Rd
City
Centralia
State
Washington
Zip
98531-9071
Phone Number
360-523-8396
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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