Healthcare Provider Details

I. General information

NPI: 1891197190
Provider Name (Legal Business Name): DANIELLE H BRADSHAW LMHC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE HARRINGTON DIXON LMHC, LCPC

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 5TH ST STE 200
MUKILTEO WA
98275-1581
US

IV. Provider business mailing address

4711 NORTHPORT DR
MUKILTEO WA
98275-6014
US

V. Phone/Fax

Practice location:
  • Phone: 425-359-6895
  • Fax:
Mailing address:
  • Phone: 425-359-6895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-7323
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60916576
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: