Provider Demographics
NPI:1114041860
Name:DANIELS, KATHY (KATHY DANIELS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:KATHY DANIELS
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:PFLEIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:1800 112TH AVE NE
Mailing Address - Street 2:SUITE 220W
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2993
Mailing Address - Country:US
Mailing Address - Phone:425-452-8550
Mailing Address - Fax:425-451-1213
Practice Address - Street 1:1800 112TH AVE NE
Practice Address - Street 2:SUITE 220W
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2993
Practice Address - Country:US
Practice Address - Phone:425-452-8550
Practice Address - Fax:425-451-1213
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00004739OtherLICENSED MENTAL HEALTH CO