Provider Demographics
NPI:1871910463
Name:CABRERA, LEONORA (MA LMCHA)
Entity type:Individual
Prefix:
First Name:LEONORA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MA LMCHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 NW 83RD ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4034
Mailing Address - Country:US
Mailing Address - Phone:206-354-1915
Mailing Address - Fax:
Practice Address - Street 1:1800 NW MARKET ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3900
Practice Address - Country:US
Practice Address - Phone:206-354-1915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60315411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health