Provider Demographics
NPI:1124480876
Name:ZOLOTH, AMY CHRISTA (LMHCA, SUDP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:CHRISTA
Last Name:ZOLOTH
Suffix:
Gender:F
Credentials:LMHCA, SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21907 64TH AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-6200
Mailing Address - Country:US
Mailing Address - Phone:425-640-7009
Mailing Address - Fax:425-248-4703
Practice Address - Street 1:21907 64TH AVE W STE 200
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-6200
Practice Address - Country:US
Practice Address - Phone:425-249-7017
Practice Address - Fax:425-640-9600
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60544153101YA0400X
WA60663705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)