Provider Demographics
NPI:1174329148
Name:BLEIFUSS, ALYSSA MARIE (LMHCA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:BLEIFUSS
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:KINGSBERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHCA
Mailing Address - Street 1:44517 FIR RD
Mailing Address - Street 2:
Mailing Address - City:GOLD BAR
Mailing Address - State:WA
Mailing Address - Zip Code:98251-9383
Mailing Address - Country:US
Mailing Address - Phone:206-300-1100
Mailing Address - Fax:
Practice Address - Street 1:921 1ST ST
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2906
Practice Address - Country:US
Practice Address - Phone:206-300-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61574098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health