Provider Demographics
NPI:1447411871
Name:WELLMAN, JODI (LMHC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 1ST AVE STE 531
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2229
Mailing Address - Country:US
Mailing Address - Phone:206-306-6555
Mailing Address - Fax:
Practice Address - Street 1:600 1ST AVE STE 531
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2229
Practice Address - Country:US
Practice Address - Phone:206-306-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60018014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health