Provider Demographics
NPI:1275823205
Name:SMITH, LINDA KAYE (MA,LMHC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAYE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 BOYLSTON AVE E APT 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3153
Mailing Address - Country:US
Mailing Address - Phone:760-877-7802
Mailing Address - Fax:
Practice Address - Street 1:14216 NE 21ST ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3720
Practice Address - Country:US
Practice Address - Phone:425-653-5025
Practice Address - Fax:425-653-4910
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60353362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health