Provider Demographics
NPI:1831136373
Name:EVELETH, NANCY J (LMHC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:EVELETH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6219
Mailing Address - Country:US
Mailing Address - Phone:425-690-3414
Mailing Address - Fax:425-690-9414
Practice Address - Street 1:4445 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6219
Practice Address - Country:US
Practice Address - Phone:425-690-3414
Practice Address - Fax:425-690-9414
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003999101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor