Provider Demographics
NPI:1205595931
Name:KOTEWA, BRENDA KAY (LPC, NCC, LMHC)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:KAY
Last Name:KOTEWA
Suffix:
Gender:F
Credentials:LPC, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 E KELLOGG RD APT F5
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8121
Mailing Address - Country:US
Mailing Address - Phone:208-484-8568
Mailing Address - Fax:
Practice Address - Street 1:186 E KELLOGG RD APT F5
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8121
Practice Address - Country:US
Practice Address - Phone:208-484-8568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
WALH61442623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health