Provider Demographics
NPI:1992914519
Name:TRLICA, REBECCA MCKINNEY (MA, LMHC, LMFT)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MCKINNEY
Last Name:TRLICA
Suffix:
Gender:F
Credentials:MA, LMHC, LMFT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31981
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-0081
Mailing Address - Country:US
Mailing Address - Phone:206-898-2786
Mailing Address - Fax:
Practice Address - Street 1:619 N 35TH ST
Practice Address - Street 2:SUITE #202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8642
Practice Address - Country:US
Practice Address - Phone:206-898-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60125317106H00000X
WALH00010948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health