Provider Demographics
NPI:1558803908
Name:SHAMATHA PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:SHAMATHA PSYCHOTHERAPY, INC.
Other - Org Name:BART OZRETICH, LICSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:OZRETICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:650-336-5384
Mailing Address - Street 1:2806 E DENNY WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3126
Mailing Address - Country:US
Mailing Address - Phone:206-769-5685
Mailing Address - Fax:844-787-9886
Practice Address - Street 1:5425 RAINIER AVE S STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2455
Practice Address - Country:US
Practice Address - Phone:650-336-5384
Practice Address - Fax:844-787-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000093701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty