Provider Demographics
NPI:1720653413
Name:HEISLEY, ANNABELLE (LMHC)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:
Last Name:HEISLEY
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 1:3406 15TH AVE W APT 6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1648
Mailing Address - Country:US
Mailing Address - Phone:630-618-8859
Mailing Address - Fax:
Practice Address - Street 1:320 NE 97TH ST STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2042
Practice Address - Country:US
Practice Address - Phone:971-208-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH61279464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health