Provider Demographics
NPI: | 1245462308 |
---|---|
Name: | BATTERSON ECTON, THOMAS AARON (LMHC) |
Entity type: | Individual |
Prefix: | MR |
First Name: | THOMAS |
Middle Name: | AARON |
Last Name: | BATTERSON ECTON |
Suffix: | |
Gender: | M |
Credentials: | LMHC |
Other - Prefix: | |
Other - First Name: | THOMAS |
Other - Middle Name: | AARON |
Other - Last Name: | ECTON |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | 1600 E OLIVE ST |
Mailing Address - Street 2: | SOUND MENTAL HEALTH |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98122-2735 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-302-2200 |
Mailing Address - Fax: | 206-302-2210 |
Practice Address - Street 1: | 6400 SOUTHCENTER BLVD |
Practice Address - Street 2: | SOUND MENTAL HEALTH |
Practice Address - City: | TUKWILA |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98188-2547 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-444-3600 |
Practice Address - Fax: | 206-444-3610 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-08-21 |
Last Update Date: | 2016-12-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | CP60349980 | 101YA0400X |
WA | LH60282553 | 101YM0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |