MEDICARE: MONIQUE THAKKAR MHC.LH.70035164

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	101YM0800X	Mental Health Counselor	MHC.LH.70035164	WA

General Provider Information

NPI Number	:	1588441786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE THAKKAR MHC.LH.70035164

Provider Business Mailing Address
First Line	:	10041 MARY AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98177-5326
Country	:	US
Telephone Number	:	253-359-4173
Fax Number	:

Provider Business Practice Location Address
First Line	:	5413 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-6168
Country	:	US
Telephone Number	:	253-359-4173
Fax Number	:

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

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	01/26/2026

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