Provider Demographics
NPI:1457241127
Name:SOIL AND SEA PSYCHOTHERAPY
Entity type:Organization
Organization Name:SOIL AND SEA PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENNAROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINZO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:310-567-5593
Mailing Address - Street 1:213 N 85TH ST PH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 N 85TH ST PH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3603
Practice Address - Country:US
Practice Address - Phone:425-405-0263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty