Provider Demographics
NPI:1801185160
Name:KALLMAN, MARISA A (MA, LMHC, CP)
Entity Type:Individual
Prefix:MS
First Name:MARISA
Middle Name:A
Last Name:KALLMAN
Suffix:
Gender:F
Credentials:MA, LMHC, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WESTLAKE AVE N
Mailing Address - Street 2:SUITE #206
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2704
Mailing Address - Country:US
Mailing Address - Phone:206-282-1699
Mailing Address - Fax:
Practice Address - Street 1:1800 WESTLAKE AVE N
Practice Address - Street 2:SUITE #206
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2704
Practice Address - Country:US
Practice Address - Phone:206-282-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60161636101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health