Healthcare Provider Details
I. General information
NPI: 1235254251
Provider Name (Legal Business Name): LYNN ELWOOD LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1812 E MADISON ST SUITE 203
SEATTLE WA
98122-2843
US
IV. Provider business mailing address
1812 E MADISON ST SUITE 203
SEATTLE WA
98122-2843
US
V. Phone/Fax
- Phone: 206-856-5896
- Fax:
- Phone: 206-856-5896
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | RC00038923 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LH00011282 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: