Provider Demographics
NPI:1942883632
Name:KAKALECIK, CHRISTINE L (MSFPSY, CTSS, PAI)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:KAKALECIK
Suffix:
Gender:F
Credentials:MSFPSY, CTSS, PAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19201 120TH AVE NE STE 108
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-9523
Mailing Address - Country:US
Mailing Address - Phone:425-485-6541
Mailing Address - Fax:425-485-4154
Practice Address - Street 1:9406 17TH PL NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-8590
Practice Address - Country:US
Practice Address - Phone:425-343-5442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health