Healthcare Provider Details

I. General information

NPI: 1205238599
Provider Name (Legal Business Name): MICHELLI SIMPSON LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLI SIMPSON M.A

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 17TH PL S SEA MAR COMMUNITY MENTAL HEALTH CENTER
SEATTLE WA
98168-1615
US

IV. Provider business mailing address

10001 17TH PL S SEA MAR COMMUNITY MENTAL HEALTH CENTER
SEATTLE WA
98168-1615
US

V. Phone/Fax

Practice location:
  • Phone: 206-766-6976
  • Fax: 206-766-6993
Mailing address:
  • Phone: 206-766-6976
  • Fax: 206-766-6993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC 60599008
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: