Provider Demographics
NPI:1649483439
Name:ANDERSON, JOANNE AUERETT (LMHC)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:AUERETT
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:A
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13901 NE 175TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-481-7479
Mailing Address - Fax:425-486-7165
Practice Address - Street 1:13901 NE 175TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-481-7479
Practice Address - Fax:425-486-7165
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00003949OtherLICENSED MENTAL HEALTH