Provider Demographics
NPI:1477842110
Name:PATRICK, EMILY (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PATRICK
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 224TH PL SW
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8167
Mailing Address - Country:US
Mailing Address - Phone:206-795-9021
Mailing Address - Fax:
Practice Address - Street 1:2931 224TH PL SW
Practice Address - Street 2:
Practice Address - City:BRIER
Practice Address - State:WA
Practice Address - Zip Code:98036-8167
Practice Address - Country:US
Practice Address - Phone:206-795-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60160393101YM0800X
WALH60555425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health