Healthcare Provider Details

I. General information

NPI: 1548319072
Provider Name (Legal Business Name): JOEY DD PICKERING MA, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 02/02/2020
Certification Date: 02/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S ORCAS ST SUITE 218
SEATTLE WA
98108-2652
US

IV. Provider business mailing address

650 S ORCAS ST SUITE 218
SEATTLE WA
98108-2652
US

V. Phone/Fax

Practice location:
  • Phone: 206-550-3830
  • Fax: 888-965-3605
Mailing address:
  • Phone: 206-550-3830
  • Fax: 888-965-3605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00010832
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: