Provider Demographics
NPI:1417613795
Name:OLIVEIRA BARONI, JAQUELINE (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JAQUELINE
Middle Name:
Last Name:OLIVEIRA BARONI
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:JAQUELINE
Other - Middle Name:APARECIDA
Other - Last Name:FEITOSA DE OLIVEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 LENORA ST
Mailing Address - Street 2:PMB 6172
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2411
Mailing Address - Country:US
Mailing Address - Phone:206-457-3133
Mailing Address - Fax:
Practice Address - Street 1:12926 VIXEN CT
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-3111
Practice Address - Country:US
Practice Address - Phone:206-457-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH.61242000101YM0800X
VA0732008709101YM0800X
WAMC61205026101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health