Provider Demographics
NPI:1932501731
Name:BRINK, HALEY (LMFT)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NE 45TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4683
Mailing Address - Country:US
Mailing Address - Phone:206-926-9087
Mailing Address - Fax:206-632-7685
Practice Address - Street 1:1100 NE 45TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4683
Practice Address - Country:US
Practice Address - Phone:206-926-9087
Practice Address - Fax:206-632-7685
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60450571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist