Provider Demographics
NPI:1184459331
Name:SATALICK, JENENE (MA, LMHCA)
Entity type:Individual
Prefix:
First Name:JENENE
Middle Name:
Last Name:SATALICK
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 SW 148TH ST # 1018
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1924
Mailing Address - Country:US
Mailing Address - Phone:206-450-0530
Mailing Address - Fax:
Practice Address - Street 1:1836 WESTLAKE AVE N STE 300B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2781
Practice Address - Country:US
Practice Address - Phone:206-450-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61493935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health