Provider Demographics
NPI:1265817266
Name:LEMOULT, DOROTHY (LMHC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:LEMOULT
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 1:4742 42ND AVE SW
Mailing Address - Street 2:#269
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4553
Mailing Address - Country:US
Mailing Address - Phone:206-395-4441
Mailing Address - Fax:
Practice Address - Street 1:4316 SW OTHELLO ST # 15
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-2074
Practice Address - Country:US
Practice Address - Phone:206-395-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60925467101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health