Provider Demographics
NPI:1053656579
Name:ANDRIGNIS, MARIAH Z (LICSW)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:Z
Last Name:ANDRIGNIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:N
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15530 BOTHELL WAY NE APT A6
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-6769
Mailing Address - Country:US
Mailing Address - Phone:970-402-7520
Mailing Address - Fax:
Practice Address - Street 1:1600 S LANE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2810
Practice Address - Country:US
Practice Address - Phone:206-682-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60857864101YA0400X
COACB-7431101YA0400X
WACG60580923101YM0800X
WALW609399521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health