Healthcare Provider Details

I. General information

NPI: 1649681297
Provider Name (Legal Business Name): JOHANNA SARAH KENNEMER MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JOHANNA SARAH STERN

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19410 HIGHWAY 99 STE A-124
LYNNWOOD WA
98036-5102
US

IV. Provider business mailing address

19410 HIGHWAY 99 STE A-124
LYNNWOOD WA
98036-5102
US

V. Phone/Fax

Practice location:
  • Phone: 206-715-5230
  • Fax: 206-326-1160
Mailing address:
  • Phone: 206-715-5230
  • Fax: 206-326-1160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60432644
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number85774
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: