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General NPI Number Information
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NPI Number | 1154025831
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Entity Type | Organization
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Legal Business Name | TALK HEAL THRIVE PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 5608 17TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-5232
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Country | US
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Telephone | 206-672-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 5608 17TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-5232
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Country | US
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Telephone | 206-672-3202
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KIM KELLER
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Credential |
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Telephone | 206-672-3202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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