Provider Demographics
NPI:1518305713
Name:WIND, KATHY SUE (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:SUE
Last Name:WIND
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUSIE
Other - Middle Name:
Other - Last Name:WIND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:21712 58TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3128
Mailing Address - Country:US
Mailing Address - Phone:206-465-5045
Mailing Address - Fax:
Practice Address - Street 1:21712 58TH AVE W
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-3128
Practice Address - Country:US
Practice Address - Phone:206-465-5045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00007490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health