MEDICARE: CHRISTI PROFFITT MA, LMHC, RDT

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	101200000X	Drama Therapist	715
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CO60565391	WA
3	101YM0800X	Mental Health Counselor	MC60687260	WA

General Provider Information

NPI Number	:	1962933044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTI PROFFITT MA, LMHC, RDT

Provider Business Mailing Address
First Line	:	1833 N 105TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8973
Country	:	US
Telephone Number	:	206-823-1563
Fax Number	:	206-501-4752

Provider Business Practice Location Address
First Line	:	1833 N 105TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8973
Country	:	US
Telephone Number	:	206-823-1563
Fax Number	:	206-501-4752

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

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	02/23/2023

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