Healthcare Provider Details
I. General information
NPI: 1558732073
Provider Name (Legal Business Name): CIARA PEMBERTON M.A., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/09/2015
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9800 4TH AVE NE
SEATTLE WA
98115-2152
US
IV. Provider business mailing address
446 N 130TH ST
SEATTLE WA
98133-7910
US
V. Phone/Fax
- Phone: 206-302-1200
- Fax: 877-516-8135
- Phone: 504-940-4013
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: