Provider Demographics
NPI:1760179568
Name:THAYIL, ELIZABETH SLOANE (LMHCA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SLOANE
Last Name:THAYIL
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:S
Other - Last Name:THAYIL-BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 S JACKSON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2883
Mailing Address - Country:US
Mailing Address - Phone:608-622-1600
Mailing Address - Fax:
Practice Address - Street 1:1213 5TH PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5645
Practice Address - Country:US
Practice Address - Phone:608-622-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61423830101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor