Provider Demographics
NPI:1629133665
Name:LENHART, ELONA R (MH)
Entity Type:Individual
Prefix:
First Name:ELONA
Middle Name:R
Last Name:LENHART
Suffix:
Gender:F
Credentials:MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34584
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1584
Mailing Address - Country:US
Mailing Address - Phone:509-241-7349
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:5002 KITSAP WAY
Practice Address - Street 2:#206
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2359
Practice Address - Country:US
Practice Address - Phone:360-405-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMH30002840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8541229Medicaid