Provider Demographics
NPI:1801202122
Name:TOTH, KEVIN (CDP)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:TOTH
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 3RD AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2385
Mailing Address - Country:US
Mailing Address - Phone:206-471-9378
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:2133 3RD AVENUE
Practice Address - Street 2:SUITE 116
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2735
Practice Address - Country:US
Practice Address - Phone:206-471-9378
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60570726101YA0400X
WACG60490938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health