Healthcare Provider Details

I. General information

NPI: 1962933044
Provider Name (Legal Business Name): CHRISTI PROFFITT MA, LMHC, RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 N 105TH ST
SEATTLE WA
98133-8973
US

IV. Provider business mailing address

1833 N 105TH ST
SEATTLE WA
98133-8973
US

V. Phone/Fax

Practice location:
  • Phone: 206-823-1563
  • Fax: 206-501-4752
Mailing address:
  • Phone: 206-823-1563
  • Fax: 206-501-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number715
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO60565391
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60687260
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: