Provider Demographics
NPI:1689960213
Name:LUOPA, BYANN K (MTS, LMHC)
Entity Type:Individual
Prefix:
First Name:BYANN
Middle Name:K
Last Name:LUOPA
Suffix:
Gender:F
Credentials:MTS, LMHC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:K
Other - Last Name:LUOPA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MTS, LMHC
Mailing Address - Street 1:16102 70TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4276
Mailing Address - Country:US
Mailing Address - Phone:206-427-4524
Mailing Address - Fax:
Practice Address - Street 1:406 MAIN ST
Practice Address - Street 2:SUITE 102B
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3166
Practice Address - Country:US
Practice Address - Phone:206-427-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health