Provider Demographics
NPI:1164276531
Name:HARBORLIGHT PSYCHOTHERAPY PLLC
Entity Type:Organization
Organization Name:HARBORLIGHT PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-492-4805
Mailing Address - Street 1:1106 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5010
Mailing Address - Country:US
Mailing Address - Phone:206-920-6821
Mailing Address - Fax:626-884-1516
Practice Address - Street 1:5100 S DAWSON ST STE 103
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2100
Practice Address - Country:US
Practice Address - Phone:360-492-4805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty