Provider Demographics
NPI:1932680865
Name:VAN NESS, ENELY (MA, LMHC, MHP)
Entity Type:Individual
Prefix:
First Name:ENELY
Middle Name:
Last Name:VAN NESS
Suffix:
Gender:F
Credentials:MA, LMHC, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 WEAVER RD NW UNIT A2
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-4614
Mailing Address - Country:US
Mailing Address - Phone:206-300-9995
Mailing Address - Fax:
Practice Address - Street 1:520 2ND AVE W APT 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3977
Practice Address - Country:US
Practice Address - Phone:206-603-0053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WAMC60932732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator