Provider Demographics
NPI:1669219069
Name:HEARTWOOD PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:HEARTWOOD PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOUSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:206-451-7332
Mailing Address - Street 1:600 N 36TH ST STE 224
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8697
Mailing Address - Country:US
Mailing Address - Phone:206-451-7332
Mailing Address - Fax:
Practice Address - Street 1:600 N 36TH ST STE 224
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8697
Practice Address - Country:US
Practice Address - Phone:206-451-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty