Healthcare Provider Details

I. General information

NPI: 1598247256
Provider Name (Legal Business Name): BARBARA J BENNETT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12603 NE 132ND ST APT D
KIRKLAND WA
98034-3110
US

IV. Provider business mailing address

12603 NE 132ND ST APT D
KIRKLAND WA
98034-3110
US

V. Phone/Fax

Practice location:
  • Phone: 757-675-3603
  • Fax:
Mailing address:
  • Phone: 757-675-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH60596034
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60596034
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: