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NPI Code Detail

MEDICARE: MS. KAREN ELIZABETH LIZZY LMHCA, CDP

MEDICARE: MS. KAREN ELIZABETH LIZZY LMHCA, CDP
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60413662WA
2101YM0800XMental Health CounselorMC60310943WA

General Provider Information

NPI Number : 1467621060
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN ELIZABETH LIZZY LMHCA, CDP
Provider Business Mailing Address
First Line : 15455 65TH AVE S
Second Line :
City : TUKWILA
State : WA
Zip : 98188-2534
Country : US
Telephone Number : 206-721-5170
Fax Number : 206-721-6288
Provider Business Practice Location Address
First Line : 15455 65TH AVE S
Second Line :
City : TUKWILA
State : WA
Zip : 98188-2534
Country : US
Telephone Number : 206-721-5170
Fax Number : 206-721-6288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 02/11/2014

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