MEDICARE: ANTHONY RELLA MA, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	MC60408047	WA
2	101YM0800X	Mental Health Counselor
3	101YM0800X	Mental Health Counselor	LH60608531	WA

General Provider Information

NPI Number	:	1265793764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY RELLA MA, LMHC

Provider Business Mailing Address
First Line	:	1833 N 105TH ST STE 101-6
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8973
Country	:	US
Telephone Number	:	206-395-4925
Fax Number	:	206-395-4925

Provider Business Practice Location Address
First Line	:	1833 N 105TH ST STE 101-6
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8973
Country	:	US
Telephone Number	:	206-395-4925
Fax Number	:	206-395-4925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	11/14/2024

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