Provider Demographics
NPI:1083853592
Name:KOSS, HEIDI BETH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:BETH
Last Name:KOSS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:BETH
Other - Last Name:KOSS-NOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMCH
Mailing Address - Street 1:13128 TOTEM LAKE BLVD NE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2953
Mailing Address - Country:US
Mailing Address - Phone:425-821-1810
Mailing Address - Fax:425-823-1231
Practice Address - Street 1:13128 TOTEM LAKE BLVD NE
Practice Address - Street 2:SUITE 206
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2953
Practice Address - Country:US
Practice Address - Phone:425-821-1810
Practice Address - Fax:425-823-1231
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-08
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60334364101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health