Provider Demographics
NPI:1205023124
Name:CREECH, MARY CARTER (LHMC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CARTER
Last Name:CREECH
Suffix:
Gender:F
Credentials:LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3240
Mailing Address - Country:US
Mailing Address - Phone:206-409-9355
Mailing Address - Fax:206-325-1218
Practice Address - Street 1:1523 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4013
Practice Address - Country:US
Practice Address - Phone:206-409-9355
Practice Address - Fax:206-325-1218
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health