Healthcare Provider Details

I. General information

NPI: 1366110850
Provider Name (Legal Business Name): SEATTLE PSYCHOTHERAPY COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 E GREEN LAKE WAY N STE 255
SEATTLE WA
98115-5400
US

IV. Provider business mailing address

6800 E GREEN LAKE WAY N STE 255
SEATTLE WA
98115-5400
US

V. Phone/Fax

Practice location:
  • Phone: 206-856-5896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LYNN ELWOOD
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 206-856-5896