Healthcare Provider Details

I. General information

NPI: 1447830385
Provider Name (Legal Business Name): DREAM LIFE OUT LOUD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BROADWAY STE 130
SEATTLE WA
98122-5381
US

IV. Provider business mailing address

600 BROADWAY STE 130
SEATTLE WA
98122-5381
US

V. Phone/Fax

Practice location:
  • Phone: 206-338-6688
  • Fax:
Mailing address:
  • Phone: 206-338-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE NICOLE HENRY
Title or Position: FOUNDER & CLINICAL
Credential: LF61614700
Phone: 206-338-6688