Provider Demographics
NPI:1609904713
Name:UNTERREINER, KATHLEEN YOUNG (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:YOUNG
Last Name:UNTERREINER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 SW AVALON WAY APT 411
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-2887
Mailing Address - Country:US
Mailing Address - Phone:206-419-4890
Mailing Address - Fax:
Practice Address - Street 1:3261 SW AVALON WAY APT 411
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2887
Practice Address - Country:US
Practice Address - Phone:206-419-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3200101YM0800X
WALW601967921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health