Healthcare Provider Details

I. General information

NPI: 1700529914
Provider Name (Legal Business Name): GREENLEAF COUNSELING & CONSULTATION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 04/15/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 AIRPORT WAY S STE 418
SEATTLE WA
98134-2173
US

IV. Provider business mailing address

3250 AIRPORT WAY S STE 418
SEATTLE WA
98134-2173
US

V. Phone/Fax

Practice location:
  • Phone: 206-494-3377
  • Fax: 206-590-5920
Mailing address:
  • Phone: 206-494-3377
  • Fax: 206-590-5920

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: KATY GREENLEAF
Title or Position: OWNER
Credential: LMHC
Phone: 206-494-3377