Provider Demographics
NPI:1508337064
Name:TAETS VON AMERONGEN, ELIZABETH ROSE (LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ROSE
Last Name:TAETS VON AMERONGEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:SIERRA WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:701 HARRISON AVE UNIT 131
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98231-7006
Mailing Address - Country:US
Mailing Address - Phone:929-399-3414
Mailing Address - Fax:
Practice Address - Street 1:701 HARRISON AVE UNIT 131
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98231-7006
Practice Address - Country:US
Practice Address - Phone:929-399-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61093280101YM0800X
ORC5091101YP2500X, 101YP2500X
COLPC.0017007101YP2500X
TX74902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health