Healthcare Provider Details

I. General information

NPI: 1417428061
Provider Name (Legal Business Name): KELSEY LAULAINEN MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELSEY PAULSEN

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 01/16/2021
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 6TH AVE STE 826
SEATTLE WA
98121-2593
US

IV. Provider business mailing address

2033 6TH AVE STE 826
SEATTLE WA
98121-2593
US

V. Phone/Fax

Practice location:
  • Phone: 206-414-8918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60756174
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60927952
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: