Provider Demographics
NPI:1205591682
Name:THERAPY INTO ACTION, PLLC
Entity type:Organization
Organization Name:THERAPY INTO ACTION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:ADRIANA
Authorized Official - Last Name:KALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, CP
Authorized Official - Phone:206-282-1699
Mailing Address - Street 1:13116 229TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8504
Mailing Address - Country:US
Mailing Address - Phone:206-282-1699
Mailing Address - Fax:206-962-3166
Practice Address - Street 1:1800 WESTLAKE AVE N STE 206
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2764
Practice Address - Country:US
Practice Address - Phone:206-282-1699
Practice Address - Fax:206-962-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801185160OtherNPI