Provider Demographics
NPI:1144594342
Name:HEMMERT, ELIZABETH DEVON (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DEVON
Last Name:HEMMERT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 RAINIER AVE S
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2085
Mailing Address - Country:US
Mailing Address - Phone:206-678-7062
Mailing Address - Fax:
Practice Address - Street 1:18537 1ST AVE S STE B
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-1867
Practice Address - Country:US
Practice Address - Phone:206-946-6946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602669331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty