Provider Demographics
NPI:1083171979
Name:NORMAN, MARY K (LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-0636
Mailing Address - Country:US
Mailing Address - Phone:206-432-0208
Mailing Address - Fax:
Practice Address - Street 1:7100 FORT DENT WAY
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-7500
Practice Address - Country:US
Practice Address - Phone:206-432-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI529101YM0800X
WALH61071775101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health