Healthcare Provider Details

I. General information

NPI: 1679776686
Provider Name (Legal Business Name): HEATHER CARRIE GUIBERSON LMHC, CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER ROBINSON LMHC, CDP

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 EVANSTON AVE N #203
SEATTLE WA
98103-8626
US

IV. Provider business mailing address

19544 FOREST PARK DR NE UNIT A
SHORELINE WA
98155-1218
US

V. Phone/Fax

Practice location:
  • Phone: 206-851-0272
  • Fax:
Mailing address:
  • Phone: 206-851-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60104339
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberRC00056431
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: