Healthcare Provider Details

I. General information

NPI: 1467718890
Provider Name (Legal Business Name): ADRIANA PRENGLER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 112TH AVE SE SUITE 100
BELLEVUE WA
98004-6901
US

IV. Provider business mailing address

4096 173RD PL SE
BELLEVUE WA
98008-5928
US

V. Phone/Fax

Practice location:
  • Phone: 425-445-5272
  • Fax:
Mailing address:
  • Phone: 425-445-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60275594
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateZZ
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1361
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: