Provider Demographics
NPI:1558706002
Name:CHAMBERLIN, ALYSSA EVON (MA, LMHC, MHP, SUDP)
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:EVON
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:MA, LMHC, MHP, SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 108TH AVE NE
Mailing Address - Street 2:SUITE #204, VILLAGE OFFICE PARK
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-7613
Mailing Address - Country:US
Mailing Address - Phone:425-242-1713
Mailing Address - Fax:
Practice Address - Street 1:3805 108TH AVE NE
Practice Address - Street 2:SUITE #204, VILLAGE OFFICE PARK
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7613
Practice Address - Country:US
Practice Address - Phone:425-242-1713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60764023101YM0800X
WACP61421569101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)