Healthcare Provider Details

I. General information

NPI: 1962221135
Provider Name (Legal Business Name): RONG HUANG LMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 03/09/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 114TH AVE SE STE 224
BELLEVUE WA
98004-6905
US

IV. Provider business mailing address

1621 114TH AVE SE STE 224
BELLEVUE WA
98004-6905
US

V. Phone/Fax

Practice location:
  • Phone: 425-332-5336
  • Fax:
Mailing address:
  • Phone: 425-332-5336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61645246
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: