Provider Demographics
NPI:1356684252
Name:HENDRICKS SKENDER, MARY ANN (MSW, LSWAIC, CDPT)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:HENDRICKS SKENDER
Suffix:
Gender:F
Credentials:MSW, LSWAIC, CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:400 YESLER WAY
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2683
Practice Address - Country:US
Practice Address - Phone:206-669-0833
Practice Address - Fax:206-726-5742
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60269858101YA0400X
WASC60269721104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker