Provider Demographics
NPI:1316460900
Name:ZHILYAEVA, KSENIA (LMHC)
Entity type:Individual
Prefix:
First Name:KSENIA
Middle Name:
Last Name:ZHILYAEVA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SE 102ND AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-4033
Mailing Address - Country:US
Mailing Address - Phone:650-521-4549
Mailing Address - Fax:
Practice Address - Street 1:210 SE 102ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4033
Practice Address - Country:US
Practice Address - Phone:650-521-4549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61022330101YM0800X
WALH61268275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health