Provider Demographics
NPI:1104301795
Name:GASKINS, ANNE (MA, LMHC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:GASKINS
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 15TH AVE S STE 103
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1874
Mailing Address - Country:US
Mailing Address - Phone:206-926-9757
Mailing Address - Fax:
Practice Address - Street 1:4501 15TH AVE S STE 103
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1874
Practice Address - Country:US
Practice Address - Phone:206-926-9757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2021-10-07
Deactivation Date:2021-09-24
Deactivation Code:
Reactivation Date:2021-10-07
Provider Licenses
StateLicense IDTaxonomies
WA61156149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health