Basic Information
| Provider Information | |||||||||
| NPI: | 1790021582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAVALERI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | VINCENT | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LMHCA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CAVALERI | ||||||||
| OtherFirstName: | JOSEPH | ||||||||
| OtherMiddleName: | MCDONALD | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9330 59TH AVE SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984992858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535817020 | ||||||||
| FaxNumber: | 2536305140 | ||||||||
| Practice Location | |||||||||
| Address1: | 9330 59TH AVE SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984992858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535817020 | ||||||||
| FaxNumber: | 2536305140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2012 | ||||||||
| LastUpdateDate: | 12/24/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | MC 60160902 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.