Provider Demographics
NPI:1083899470
Name:DANIELSON ADDINGTON, BETTY ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:DANIELSON ADDINGTON
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 4141
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-0141
Mailing Address - Country:US
Mailing Address - Phone:360-352-1052
Mailing Address - Fax:360-352-0956
Practice Address - Street 1:1610 BISHOP RD SW
Practice Address - Street 2:SUITE 105
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7303
Practice Address - Country:US
Practice Address - Phone:360-352-1052
Practice Address - Fax:360-352-0956
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009740101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00009740OtherWASHINGTON STATE LICENSE