| Roanoke Park Counseling | |
|
2601 Broadway E Seattle WA 98102-3906 | |
| (206) 323-7131 | |
| (206) 322-4078 |
| Full Name | Roanoke Park Counseling |
|---|---|
| Speciality | Counselor |
| Location | 2601 Broadway E, Seattle, Washington |
| Authorized Official Name and Position | Janice M Palm (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2063237131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roanoke Park Counseling 2601 Broadway E Seattle WA 98102-3906 Ph: (206) 323-7131 | Roanoke Park Counseling 2601 Broadway E Seattle WA 98102-3906 Ph: (206) 323-7131 |
| NPI Number | 1316180698 |
|---|---|
| Provider Enumeration Date | 04/15/2009 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Medicare PECOS PAC ID | 2668986605 |
|---|---|
| Medicare Enrollment ID | O20250710001534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316180698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Janice Marie Palm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700920204 PECOS PAC ID: 4587106570 Enrollment ID: I20240605002983 |
| Provider Name | Julia D Laibson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528369931 PECOS PAC ID: 9537655576 Enrollment ID: I20251230000921 |
| Provider Name | Amanda Franklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821393679 PECOS PAC ID: 9638659675 Enrollment ID: I20260217004386 |
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