Healthcare Provider Details

I. General information

NPI: 1841431244
Provider Name (Legal Business Name): KATHRYN ELAINE BENEFIEL LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 MUKILTEO SPEEDWAY STE 201
MUKILTEO WA
98275-5436
US

IV. Provider business mailing address

11700 MUKILTEO SPEEDWAY STE 201
MUKILTEO WA
98275-5436
US

V. Phone/Fax

Practice location:
  • Phone: 206-331-2304
  • Fax:
Mailing address:
  • Phone: 206-331-2304
  • Fax: 206-331-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLW60125791
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: