Healthcare Provider Details

I. General information

NPI: 1265917520
Provider Name (Legal Business Name): LILY EWING COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 SW ALASKA ST
SEATTLE WA
98126-2730
US

IV. Provider business mailing address

8418 26TH AVE SW APT D
SEATTLE WA
98106-3251
US

V. Phone/Fax

Practice location:
  • Phone: 206-826-9342
  • Fax:
Mailing address:
  • Phone: 206-265-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: LILY MAIN EWING
Title or Position: LMHC
Credential: MA
Phone: 206-826-9342