Provider Demographics
NPI:1144479643
Name:LAKE UNION COUNSELING, LLC
Entity type:Organization
Organization Name:LAKE UNION COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PEER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:206-890-1214
Mailing Address - Street 1:534 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4305
Mailing Address - Country:US
Mailing Address - Phone:206-890-1214
Mailing Address - Fax:
Practice Address - Street 1:534 WESTLAKE AVE N
Practice Address - Street 2:SUITE 240
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4305
Practice Address - Country:US
Practice Address - Phone:206-890-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty