Provider Demographics
NPI:1942357694
Name:KANNEGAARD, MARY ELIZABETH (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:KANNEGAARD
Suffix:
Gender:F
Credentials:MS, LMHC
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Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:6100 SOUTHCENTER BLVD
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2442
Practice Address - Country:US
Practice Address - Phone:206-444-7800
Practice Address - Fax:206-444-7810
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WALH00005826101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health