Provider Demographics
NPI:1699324699
Name:MEAD, ANNJEANNETTE LYNAE (MS, LMHC, MHP)
Entity type:Individual
Prefix:
First Name:ANNJEANNETTE
Middle Name:LYNAE
Last Name:MEAD
Suffix:
Gender:F
Credentials:MS, LMHC, MHP
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:L
Other - Last Name:MEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4526 FEDERAL AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2132
Mailing Address - Country:US
Mailing Address - Phone:425-349-6200
Mailing Address - Fax:
Practice Address - Street 1:4526 FEDERAL AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2132
Practice Address - Country:US
Practice Address - Phone:425-349-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61081346101YM0800X
WALH61271706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health