Provider Demographics
NPI:1639247752
Name:CUDWORTH, DAVID JAMES (LMHC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:CUDWORTH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14810 89TH PL NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4766
Mailing Address - Country:US
Mailing Address - Phone:425-349-8325
Mailing Address - Fax:
Practice Address - Street 1:14810 89TH PL NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-4766
Practice Address - Country:US
Practice Address - Phone:425-381-6895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA#6644OtherREGISTERED COUNSELOR