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General NPI Number Information
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NPI Number | 1417135146
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Entity Type | Individual
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Provider Name | MARIA CAMPBELL LATHROP-SKALOS LCSW, LICSW, BCD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 15811 AMBAUM BLVD SW STE 110
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City | BURIEN
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State | WA
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Zip | 98166-3071
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Country | US
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Telephone | 206-242-8211
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Fax | 206-242-0162
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Provider Business Mailing Address
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Address Line | 15811 AMBAUM BLVD SW STE 110
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City | BURIEN
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State | WA
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Zip | 98166-3071
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Country | US
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Telephone | 206-242-8211
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Fax | 206-242-0162
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 38131
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 60870468
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3264
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License Number State | LA
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