St Jacques, Kevin Wayne

St Jacques, Kevin Wayne is an sole proprietor health care provider with primary practice located at 17508 20Th Dr Se , Bothell WA 98012-6406. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. St Jacques, Kevin Wayne can be contacted via phone (206) 495-8562.

Contact Information

Primary practice address
17508 20Th Dr Se Bothell WA 98012-6406
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH60116269 Washington
Behavioral Health & Social Service Providers / Counselor 101Y00000X LH60116269 Washington

Profile Details

NPI number 1538226444
LBN Legal business name St Jacques, Kevin Wayne
Credentials PSY.D., LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Mar 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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