Provider Demographics
NPI:1770911943
Name:HEARN, GRACE (MA,LMHCA)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:HEARN
Suffix:
Gender:F
Credentials:MA,LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98111-0298
Mailing Address - Country:US
Mailing Address - Phone:206-250-1093
Mailing Address - Fax:
Practice Address - Street 1:582 KRAMER ROAD
Practice Address - Street 2:
Practice Address - City:UNDERWOOD MOUNTAIN
Practice Address - State:WA
Practice Address - Zip Code:98651-9865
Practice Address - Country:US
Practice Address - Phone:206-250-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAMC60276945101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health