Provider Demographics
NPI:1326700683
Name:MOLGARD, TAKAKO K (LMHC)
Entity Type:Individual
Prefix:
First Name:TAKAKO
Middle Name:K
Last Name:MOLGARD
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 1:602 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4228
Mailing Address - Country:US
Mailing Address - Phone:206-201-1890
Mailing Address - Fax:
Practice Address - Street 1:614 VALLEY ST APT B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4228
Practice Address - Country:US
Practice Address - Phone:206-861-4589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61221528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health