Provider Demographics
NPI:1427380567
Name:PIERCE MA LMHC LLC, JODI P (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:P
Last Name:PIERCE MA LMHC LLC
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 1:3417 EVANSTON AVE N STE 228
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8686
Mailing Address - Country:US
Mailing Address - Phone:206-782-8867
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N STE 228
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8686
Practice Address - Country:US
Practice Address - Phone:206-225-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-30
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60147859101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health