Provider Demographics
NPI:1790188530
Name:NEGRILA, LUDMILA MONICA (MA, PCC-S, LMHC, MHP)
Entity type:Individual
Prefix:
First Name:LUDMILA
Middle Name:MONICA
Last Name:NEGRILA
Suffix:
Gender:F
Credentials:MA, PCC-S, LMHC, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 108TH AVE NE
Mailing Address - Street 2:STE. 204
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-7613
Mailing Address - Country:US
Mailing Address - Phone:425-242-1713
Mailing Address - Fax:425-242-0587
Practice Address - Street 1:3805 108TH AVE NE
Practice Address - Street 2:STE. 204
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7613
Practice Address - Country:US
Practice Address - Phone:425-242-1713
Practice Address - Fax:425-242-0587
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60146449101YM0800X
OHE.0500282-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health