Provider Demographics
NPI:1962621557
Name:EDSON, KARA R (MS, LMHC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:R
Last Name:EDSON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14920 WESTMINSTER WAY N
Mailing Address - Street 2:#1A
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6445
Mailing Address - Country:US
Mailing Address - Phone:206-409-5144
Mailing Address - Fax:
Practice Address - Street 1:14920 WESTMINSTER WAY N
Practice Address - Street 2:#1A
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6445
Practice Address - Country:US
Practice Address - Phone:206-409-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health