Provider Demographics
NPI:1215669445
Name:HISEY, ZOE RENEE (LMHCA)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:RENEE
Last Name:HISEY
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-0307
Mailing Address - Country:US
Mailing Address - Phone:425-765-9074
Mailing Address - Fax:
Practice Address - Street 1:103 MAIN AVE S STE 210
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8197
Practice Address - Country:US
Practice Address - Phone:425-765-9074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61298256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health