Individual
MICAELA LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, MSW, LICSW
Contact information
Practice address
21907 64TH AVE W STE 200, MOUNTLAKE TERRACE, WA 98043-6200
(425) 679-9295
Mailing address
20115 FOREST PARK DR NE, SHORELINE, WA 98155-1152
(425) 577-4055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61510416
WA
225700000X
Massage Therapist
MA60908528
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
12/04/2018
Last updated
07/29/2025
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