Basic Information
Provider Information
NPI: 1134464746
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: MICHAELA
MiddleName: COLLEEN
NamePrefix:  
NameSuffix:  
Credential: LMHCA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
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: 6400 SOUTHCENTER BLVD
Address2: SOUND MENTAL HEALTH
City: TUKWILA
State: WA
PostalCode: 981882547
CountryCode: US
TelephoneNumber: 2064443600
FaxNumber: 2064443610
Other Information
ProviderEnumerationDate: 12/07/2012
LastUpdateDate: 12/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XMC60301709WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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