Provider Demographics
NPI:1376729608
Name:PHILIPPS, CALEY BROOK (BA, MS LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CALEY
Middle Name:BROOK
Last Name:PHILIPPS
Suffix:
Gender:F
Credentials:BA, MS LMFT
Other - Prefix:MISS
Other - First Name:CALEY
Other - Middle Name:BROOK
Other - Last Name:SEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:500 ELLIOTT AVE W APT 314
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4355
Mailing Address - Country:US
Mailing Address - Phone:206-420-9895
Mailing Address - Fax:
Practice Address - Street 1:2206 QUEEN ANNE AVE N
Practice Address - Street 2:SUITE 303
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2370
Practice Address - Country:US
Practice Address - Phone:206-420-9895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00059793101Y00000X
WAMG 60117600106H00000X
WALF60245944106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor