Provider Demographics
NPI:1003221011
Name:SOSA, KEVIN (LMHCA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:SOSA
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25029 144TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3425
Mailing Address - Country:US
Mailing Address - Phone:253-642-6127
Mailing Address - Fax:
Practice Address - Street 1:12507 NE BEL RED RD STE 103
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2500
Practice Address - Country:US
Practice Address - Phone:253-642-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61188197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health