Provider Demographics
NPI:1265684724
Name:LORDKENAGA, RAC HEL GUINEVERE (LMHC)
Entity Type:Individual
Prefix:
First Name:RAC HEL
Middle Name:GUINEVERE
Last Name:LORDKENAGA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 6TH AVE
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3123
Mailing Address - Country:US
Mailing Address - Phone:206-419-5052
Mailing Address - Fax:206-624-7626
Practice Address - Street 1:1200 6TH AVE
Practice Address - Street 2:SUITE 2001
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3123
Practice Address - Country:US
Practice Address - Phone:206-419-5052
Practice Address - Fax:206-624-7626
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00011332101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health