Provider Demographics
NPI:1497304109
Name:STANOVSKY, CARL AXEL (LMHCA)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:AXEL
Last Name:STANOVSKY
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S LANE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2810
Mailing Address - Country:US
Mailing Address - Phone:206-682-2371
Mailing Address - Fax:
Practice Address - Street 1:20534 FERN ST NE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:WA
Practice Address - Zip Code:98342-9007
Practice Address - Country:US
Practice Address - Phone:206-659-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61349439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health