Provider Demographics
NPI:1477823201
Name:FERREIRA, FLAVIANE PENTEADO (LMHC)
Entity Type:Individual
Prefix:
First Name:FLAVIANE
Middle Name:PENTEADO
Last Name:FERREIRA
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 1:1621 114TH AVE SE STE 210
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6905
Mailing Address - Country:US
Mailing Address - Phone:425-243-2779
Mailing Address - Fax:
Practice Address - Street 1:1621 114TH AVE SE STE 210
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6905
Practice Address - Country:US
Practice Address - Phone:425-243-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60164019101YM0800X
WALH 60459683102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health