Provider Demographics
NPI:1467591248
Name:KRUPA, MARIA BEATA (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:BEATA
Last Name:KRUPA
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:BEATA
Other - Last Name:MATUSEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:521 NE 120
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-439-2595
Mailing Address - Fax:206-439-2297
Practice Address - Street 1:10740 MERIDIAN AVE N
Practice Address - Street 2:STE 203
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-439-2595
Practice Address - Fax:206-439-2297
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004962103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0646KROtherREGENCE