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General NPI Number Information
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NPI Number | 1932680865
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Entity Type | Individual
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Provider Name | ENELY VAN NESS MA, LMHC, MHP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 520 2ND AVE W APT 102
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City | SEATTLE
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State | WA
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Zip | 98119-3977
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Country | US
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Telephone | 206-603-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 WEAVER RD NW UNIT A2
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-4614
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Country | US
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Telephone | 206-300-9995
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 | MC60932732
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License Number State | WA
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