Provider Demographics
NPI:1447943840
Name:SEATTLE'S UNION GOSPEL MISSION
Entity type:Organization
Organization Name:SEATTLE'S UNION GOSPEL MISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BEHAVIORAL HEALTH
Authorized Official - Prefix:MISS
Authorized Official - First Name:KRISTIANN
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:737-276-9633
Mailing Address - Street 1:3800 S OTHELLO ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3562
Mailing Address - Country:US
Mailing Address - Phone:206-432-8412
Mailing Address - Fax:
Practice Address - Street 1:3800 S OTHELLO ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3562
Practice Address - Country:US
Practice Address - Phone:206-432-8412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty