Provider Demographics
NPI:1386798924
Name:GOETZ, SHARON MAE (LMHC LICENSED MENTAL)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MAE
Last Name:GOETZ
Suffix:
Gender:F
Credentials:LMHC LICENSED MENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11933 243RD ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-4806
Mailing Address - Country:US
Mailing Address - Phone:360-403-8579
Mailing Address - Fax:360-403-8579
Practice Address - Street 1:307 N OLYMPIC
Practice Address - Street 2:SUITE 213
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-4806
Practice Address - Country:US
Practice Address - Phone:425-308-6532
Practice Address - Fax:360-403-8579
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health