Provider Demographics
NPI:1326684754
Name:LUNDE, AMY LOUISE (LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:LUNDE
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 1:2129 MALTBY RD UNIT F204
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7468
Mailing Address - Country:US
Mailing Address - Phone:206-412-7257
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST STE 121
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3542
Practice Address - Country:US
Practice Address - Phone:206-412-7257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60728179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty