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General NPI Number Information
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NPI Number | 1679776686
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Entity Type | Individual
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Provider Name | HEATHER CARRIE GUIBERSON LMHC, CDP
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 3417 EVANSTON AVE N #203
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City | SEATTLE
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State | WA
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Zip | 98103-8626
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Country | US
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Telephone | 206-851-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 19544 FOREST PARK DR NE UNIT A
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City | SHORELINE
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State | WA
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Zip | 98155-1218
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Country | US
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Telephone | 206-851-0272
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | RC00056431
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH 60104339
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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