Provider Demographics
NPI:1770988982
Name:MAR, KAYSEE (LMHCA)
Entity type:Individual
Prefix:
First Name:KAYSEE
Middle Name:
Last Name:MAR
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:KAYSEE
Other - Middle Name:
Other - Last Name:FAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12221 NE 140TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2221
Mailing Address - Country:US
Mailing Address - Phone:425-681-6563
Mailing Address - Fax:
Practice Address - Street 1:12221 NE 140TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2221
Practice Address - Country:US
Practice Address - Phone:425-681-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60490909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health