Healthcare Provider Details

I. General information

NPI: 1043952989
Provider Name (Legal Business Name): ATRAYEE MUKHERJEE LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3639 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-6847
US

IV. Provider business mailing address

321 E 2ND ST APT 1
BLOOMINGTON IN
47401-3517
US

V. Phone/Fax

Practice location:
  • Phone: 206-695-7600
  • Fax:
Mailing address:
  • Phone: 812-369-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61269501
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: