Provider Demographics
NPI:1932740636
Name:KOSTEK, JAMIE (LMHC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:KOSTEK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 NW 96TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-2548
Mailing Address - Country:US
Mailing Address - Phone:206-581-0449
Mailing Address - Fax:
Practice Address - Street 1:5306 BALLARD AVE NW STE 309
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4366
Practice Address - Country:US
Practice Address - Phone:206-581-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61262345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health