Basic Information
Provider Information
NPI: 1154549871
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALSETTO
FirstName: PATRICIA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: CDP,LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2704 I ST NE
Address2:  
City: AUBURN
State: WA
PostalCode: 980022411
CountryCode: US
TelephoneNumber: 2538337444
FaxNumber: 2537354111
Practice Location
Address1: 33301 1ST WAY S STE C115
Address2:  
City: FEDERAL WAY
State: WA
PostalCode: 980036210
CountryCode: US
TelephoneNumber: 2536616634
FaxNumber: 2537354111
Other Information
ProviderEnumerationDate: 04/20/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XCP00001522WAX Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800XLH00009034WAX Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home