MEDICARE: SALLY NEUMANN LLC

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

General Provider Information

NPI Number	:	1851031918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALLY NEUMANN LLC

Provider Business Mailing Address
First Line	:	10213 64TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178-2312
Country	:	US
Telephone Number	:	206-999-8279
Fax Number	:

Provider Business Practice Location Address
First Line	:	10213 64TH AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98178-2312
Country	:	US
Telephone Number	:	206-999-8279
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	SARAH NEUMANN
Credential	:	LMHC
Telephone Number	:	206-999-8279

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	03/29/2022

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