Healthcare Provider Details

I. General information

NPI: 1427628999
Provider Name (Legal Business Name): KATRINA VAN STRIEN LMHCA, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 BROADWAY # A3
TACOMA WA
98402-3907
US

IV. Provider business mailing address

539 BROADWAY # A3
TACOMA WA
98402-3907
US

V. Phone/Fax

Practice location:
  • Phone: 253-234-4877
  • Fax:
Mailing address:
  • Phone: 253-234-4877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61540457
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number24-338
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: