Healthcare Provider Details

I. General information

NPI: 1548707961
Provider Name (Legal Business Name): ALANA JAECK LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 44TH AVE SW
SEATTLE WA
98116-4116
US

IV. Provider business mailing address

4505 44TH AVE SW
SEATTLE WA
98116-4116
US

V. Phone/Fax

Practice location:
  • Phone: 646-543-7878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH60707802
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60707802
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number321463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: