Provider Demographics
NPI:1306408380
Name:WOOD, DANIELLE RENAE (LMFTA, LMHCA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENAE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMFTA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70111
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98127-0111
Mailing Address - Country:US
Mailing Address - Phone:206-659-1789
Mailing Address - Fax:
Practice Address - Street 1:5424 BALLARD AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4046
Practice Address - Country:US
Practice Address - Phone:206-659-1789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60958716101YM0800X
WAMG60967290106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health