Provider Demographics
NPI:1306997978
Name:KAYE, LAUREEN (MA, LMHC)
Entity type:Individual
Prefix:
First Name:LAUREEN
Middle Name:
Last Name:KAYE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:LORRY
Other - Middle Name:
Other - Last Name:KAYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0433
Mailing Address - Country:US
Mailing Address - Phone:425-788-9920
Mailing Address - Fax:425-788-9920
Practice Address - Street 1:15321 MAIN ST NE
Practice Address - Street 2:STE #322
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8574
Practice Address - Country:US
Practice Address - Phone:425-788-9920
Practice Address - Fax:425-788-9920
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004830101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00004830OtherLICENSED MENTAL HEALTH