Provider Demographics
NPI:1477841716
Name:PARIDA, MANDY L (LMHC)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:L
Last Name:PARIDA
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 1:5450 CALIFORNIA AVE SW STE 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1577
Mailing Address - Country:US
Mailing Address - Phone:206-452-7442
Mailing Address - Fax:206-452-7442
Practice Address - Street 1:5450 CALIFORNIA AVE SW STE 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1577
Practice Address - Country:US
Practice Address - Phone:206-452-7442
Practice Address - Fax:206-452-7442
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60407097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health