Provider Demographics
NPI:1023461712
Name:KAMMERER, IZABELA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:IZABELA
Middle Name:
Last Name:KAMMERER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 PINE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3899
Mailing Address - Country:US
Mailing Address - Phone:253-217-5949
Mailing Address - Fax:
Practice Address - Street 1:314 PINE ST STE 205
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3899
Practice Address - Country:US
Practice Address - Phone:253-217-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor