Provider Demographics
NPI:1033558226
Name:ADRIANA S PRENGLER
Entity Type:Organization
Organization Name:ADRIANA S PRENGLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:425-455-0886
Mailing Address - Street 1:1450 114TH AVE SE STE 105
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6934
Mailing Address - Country:US
Mailing Address - Phone:425-455-0886
Mailing Address - Fax:
Practice Address - Street 1:1450 114TH AVE SE STE 105
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6934
Practice Address - Country:US
Practice Address - Phone:425-455-0886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 102L00000X
ZZ103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty