Provider Demographics
NPI:1851651723
Name:HOGGARD, KARIN ESTELLEDACEY (MA, LMHC, CMHS)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:ESTELLEDACEY
Last Name:HOGGARD
Suffix:
Gender:F
Credentials:MA, LMHC, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16054 INTERLAKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5744
Mailing Address - Country:US
Mailing Address - Phone:206-446-5123
Mailing Address - Fax:
Practice Address - Street 1:8521 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3101
Practice Address - Country:US
Practice Address - Phone:206-446-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60263207101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor