Provider Demographics
NPI:1629131420
Name:LUTHER, AMY RENEE (MA, MHP, LMHC)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:RENEE
Last Name:LUTHER
Suffix:
Gender:F
Credentials:MA, MHP, 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:SOUND 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:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2442
Practice Address - Country:US
Practice Address - Phone:206-444-7800
Practice Address - Fax:206-444-7810
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011371101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor