Provider Demographics
NPI:1467720631
Name:FAASSE, AMANDA K (LMHC, SUDP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:K
Last Name:FAASSE
Suffix:
Gender:F
Credentials:LMHC, SUDP
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:K
Other - Last Name:HUSSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0569
Mailing Address - Country:US
Mailing Address - Phone:425-212-4200
Mailing Address - Fax:425-212-4201
Practice Address - Street 1:811 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4543
Practice Address - Country:US
Practice Address - Phone:425-212-4200
Practice Address - Fax:425-212-4201
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61141477101YA0400X
WALH60440432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)