Basic Information
| Provider Information | |||||||||
| NPI: | 1134351315 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARROLL | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MHP, AAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 E OLIVE ST | ||||||||
| Address2: | SOUND MENTAL HEALTH | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981222735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063022200 | ||||||||
| FaxNumber: | 2063022210 | ||||||||
| Practice Location | |||||||||
| Address1: | 6100 SOUTHCENTER BLVD | ||||||||
| Address2: | SOUNT MENTAL HEALTH, STE 200 | ||||||||
| City: | TUKWILA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981882441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064447800 | ||||||||
| FaxNumber: | 2064447810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2009 | ||||||||
| LastUpdateDate: | 09/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | CG60165038 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | CG60165038 | WA | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.