Provider Demographics
NPI:1801935804
Name:HODDEVIK, MAALFRID MARIE (MA, LMHC)
Entity type:Individual
Prefix:
First Name:MAALFRID
Middle Name:MARIE
Last Name:HODDEVIK
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4629-NE195TH
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155
Mailing Address - Country:US
Mailing Address - Phone:206-715-6991
Mailing Address - Fax:
Practice Address - Street 1:12360 LAKE CITY WAY NE STE 420
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5452
Practice Address - Country:US
Practice Address - Phone:206-715-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60159588101YM0800X
WARC00047945101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health