MEDICARE: SARAH MELFI-KLEIN LMHCA, SUDP

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
2	390200000X	Student in an Organized Health Care Education/Training Program
3	101Y00000X	Counselor	MC61102882	WA

General Provider Information

NPI Number	:	1790250009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MELFI-KLEIN LMHCA, SUDP

Provider Business Mailing Address
First Line	:	PO BOX 30163
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98113-0163
Country	:	US
Telephone Number	:	206-395-9064
Fax Number	:

Provider Business Practice Location Address
First Line	:	8502 INTERLAKE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4028
Country	:	US
Telephone Number	:	206-395-9064
Fax Number	:

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

Provider Enumeration Date	:	10/12/2018
Last Update Date	:	01/08/2023

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