Healthcare Provider Details
I. General information
NPI: 1477978229
Provider Name (Legal Business Name): ANGELA WOOD LMHC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/03/2014
Last Update Date: 09/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 SAND POINT WAY NE MS/ O.A.5154
SEATTLE WA
98105-3901
US
IV. Provider business mailing address
4800 SAND POINT WAY NE MS/ O.A.5154
SEATTLE WA
99105
US
V. Phone/Fax
- Phone: 206-987-6155
- Fax: 206-987-2246
- Phone: 206-987-6155
- Fax: 206-987-2246
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LH60446415 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: