Provider Demographics
NPI:1891114401
Name:YWCA
Entity Type:Organization
Organization Name:YWCA
Other - Org Name:YWCA MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERBROOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-461-4851
Mailing Address - Street 1:1118 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3001
Mailing Address - Country:US
Mailing Address - Phone:206-461-4888
Mailing Address - Fax:
Practice Address - Street 1:930 NE HIGH ST
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-7417
Practice Address - Country:US
Practice Address - Phone:425-922-6192
Practice Address - Fax:425-392-8858
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YWCA OF SEATTLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA249305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization