Provider Demographics
NPI:1295101822
Name:CALHOUN, MARA (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF WASHINGTON MEDICAL CTR
Mailing Address - Street 2:1959 NE PACIFIC ST BOX 357920
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7920
Mailing Address - Country:US
Mailing Address - Phone:206-598-4317
Mailing Address - Fax:206-598-7815
Practice Address - Street 1:UNIVERSITY OF WASHINGTON MEDICAL CTR
Practice Address - Street 2:1959 NE PACIFIC ST BOX 357920
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7920
Practice Address - Country:US
Practice Address - Phone:206-598-4317
Practice Address - Fax:206-598-7815
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605717001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical