Provider Demographics
NPI:1417127606
Name:HEALY, BETH LORRAINE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:LORRAINE
Last Name:HEALY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 2ND AVE STE 680
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3433
Mailing Address - Country:US
Mailing Address - Phone:206-826-3040
Mailing Address - Fax:866-894-7425
Practice Address - Street 1:1191 2ND AVE STE 680
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3433
Practice Address - Country:US
Practice Address - Phone:206-826-3040
Practice Address - Fax:866-894-7425
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health