Provider Demographics
NPI:1073365227
Name:LAKE COUNSELING & CONSULTING PLLC
Entity type:Organization
Organization Name:LAKE COUNSELING & CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAKELAND
Authorized Official - Middle Name:GREY
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-590-1331
Mailing Address - Street 1:10415 NE 37TH CIR BLDG 4
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7924
Mailing Address - Country:US
Mailing Address - Phone:206-590-1331
Mailing Address - Fax:
Practice Address - Street 1:10415 NE 37TH CIR BLDG 4
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7924
Practice Address - Country:US
Practice Address - Phone:206-590-1331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty