Healthcare Provider Details

I. General information

NPI: 1982089835
Provider Name (Legal Business Name): MEG BLADT MCCORMICK LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN MAE BLADT

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 SW JUNEAU ST
SEATTLE WA
98136-1621
US

IV. Provider business mailing address

5047 DELRIDGE WAY SW APT B
SEATTLE WA
98106-1361
US

V. Phone/Fax

Practice location:
  • Phone: 206-207-5395
  • Fax:
Mailing address:
  • Phone: 206-300-7852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60997009
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61166815
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: