Provider Demographics
NPI:1780747667
Name:TOWNLEY CLAYTON, KIMBERLI S (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLI
Middle Name:S
Last Name:TOWNLEY CLAYTON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:TOWNLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:14216 NE 21ST ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3720
Practice Address - Country:US
Practice Address - Phone:425-653-4900
Practice Address - Fax:425-653-4910
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001251106H00000X
WACO60523409390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program