Provider Demographics
NPI:1396815346
Name:SAMMAMISH COUNSELING
Entity Type:Organization
Organization Name:SAMMAMISH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:JON
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:425-391-7870
Mailing Address - Street 1:22803 SE 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-8101
Mailing Address - Country:US
Mailing Address - Phone:425-391-7870
Mailing Address - Fax:
Practice Address - Street 1:22803 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-8101
Practice Address - Country:US
Practice Address - Phone:425-391-7870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty