MEDICARE: SEA MAR COMMUNITY HEALTH CLINICS - BEHAVIORAL HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	RC00021359	WA

General Provider Information

NPI Number	:	1770677411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEA MAR COMMUNITY HEALTH CLINICS - BEHAVIORAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	10001 17TH PL S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98168
Country	:	US
Telephone Number	:	206-766-6976
Fax Number	:	206-766-6979

Provider Business Practice Location Address
First Line	:	10001 17TH PL S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98168
Country	:	US
Telephone Number	:	206-766-6976
Fax Number	:	206-766-6979

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MRS. CLAUDIA D'ALLEGRI
Credential	:	M.A., M.H.P
Telephone Number	:	206-764-4700

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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