Provider Demographics
NPI:1356647598
Name:KAPERICK, CARMEN SALINAS (LICSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:SALINAS
Last Name:KAPERICK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CARMEN
Other - Last Name:SALINAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1603 116TH AVE NE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3009
Mailing Address - Country:US
Mailing Address - Phone:425-646-2778
Mailing Address - Fax:
Practice Address - Street 1:1603 116TH AVE NE
Practice Address - Street 2:SUITE 114
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3009
Practice Address - Country:US
Practice Address - Phone:425-646-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-06
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000079501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical