Healthcare Provider Details

I. General information

NPI: 1891065140
Provider Name (Legal Business Name): KEREN GOTT MA, MHP, CDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8212 S MARCH POINT RD
ANACORTES WA
98221-8684
US

IV. Provider business mailing address

8212 S MARCH POINT RD
ANACORTES WA
98221-8684
US

V. Phone/Fax

Practice location:
  • Phone: 360-588-2800
  • Fax: 360-251-0863
Mailing address:
  • Phone: 360-588-2800
  • Fax: 360-251-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60142482
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO60210911
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG60142482
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: