Provider Demographics
NPI:1558423749
Name:MARCERON, DENNIS MATTHEW (MA, CDP, LMHC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:MATTHEW
Last Name:MARCERON
Suffix:
Gender:M
Credentials:MA, CDP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SEATTLE MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:6100 SOUTHCENTER BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2441
Practice Address - Country:US
Practice Address - Phone:206-444-7870
Practice Address - Fax:206-444-7910
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008187101YM0800X, 101Y00000X
WACP60247695101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor