Healthcare Provider Details

I. General information

NPI: 1235860974
Provider Name (Legal Business Name): KARA MARIE ATKINSON LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22232 17TH AVE SE
BOTHELL WA
98021-7430
US

IV. Provider business mailing address

3821 23RD AVE W
SEATTLE WA
98199-2333
US

V. Phone/Fax

Practice location:
  • Phone: 608-697-5491
  • Fax:
Mailing address:
  • Phone: 608-697-5491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61285687
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: