Provider Demographics
NPI:1235810847
Name:CONTEH, JOHN ALIE (EDD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALIE
Last Name:CONTEH
Suffix:
Gender:M
Credentials:EDD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16623 34TH AVE E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98446-1407
Mailing Address - Country:US
Mailing Address - Phone:253-283-7199
Mailing Address - Fax:
Practice Address - Street 1:2603 BRIDGEPORT WAY W STE D
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4724
Practice Address - Country:US
Practice Address - Phone:253-283-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004984101YP2500X
OHC.1901803101YP2500X
WALH61280842101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional