Provider Demographics
NPI:1306172432
Name:LODESTAR THERAPY LLC
Entity type:Organization
Organization Name:LODESTAR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:AMD
Authorized Official - Last Name:BABER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-661-5222
Mailing Address - Street 1:4500 9TH AVE NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4737
Mailing Address - Country:US
Mailing Address - Phone:206-661-5222
Mailing Address - Fax:
Practice Address - Street 1:4500 9TH AVE NE
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4737
Practice Address - Country:US
Practice Address - Phone:206-661-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-24
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000086101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty