Provider Demographics
NPI:1124502430
Name:CHAMBERLAIN, KAITLYN MARIE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:MARIE
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:KAITLYN
Other - Middle Name:MARIE
Other - Last Name:MUSSAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:324 84TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-3358
Mailing Address - Country:US
Mailing Address - Phone:847-226-0093
Mailing Address - Fax:
Practice Address - Street 1:10121 EVERGREEN WAY STE 25-244
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3885
Practice Address - Country:US
Practice Address - Phone:425-610-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60853183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health