Provider Demographics
NPI:1740470012
Name:GREENLEAF, KATY CREWE (MA, LMHC, MHP, CMHS)
Entity type:Individual
Prefix:MS
First Name:KATY
Middle Name:CREWE
Last Name:GREENLEAF
Suffix:
Gender:F
Credentials:MA, LMHC, MHP, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BOREN AVE
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3595
Mailing Address - Country:US
Mailing Address - Phone:206-755-6904
Mailing Address - Fax:206-276-0325
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3595
Practice Address - Country:US
Practice Address - Phone:206-755-6904
Practice Address - Fax:206-276-0325
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00053904101YP2500X
WALH60195286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional