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6212 75th St W Lakewood WA 98499-8368 | |
(972) 437-4698 | |
(972) 671-2087 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 6212 75th St W, Lakewood, Washington |
Authorized Official Name and Position | Jacquelyn Williams (V. P. CORPORATE COMPLIANCE) |
Authorized Official Contact | 9724374698 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2099 N Collins Blvd Suite 200 Richardson TX 75080-2698 Ph: (972) 437-4698 | 6212 75th St W Lakewood WA 98499-8368 Ph: (972) 437-4698 |
NPI Number | 1548216799 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1548216799 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | PY00001551 (Washington) | Primary |
Paul Kenneth Henry Med Lmhc Ps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9101 Bridgeport Way Sw Ste D2, Lakewood, WA 98499 Phone: 253-394-6045 | |
Lakewood Wellness Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10310 Gravelly Lake Dr Sw Ste B, Lakewood, WA 98499 Phone: 253-888-3405 | |