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Individual

MARY LOU GAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LMHC, CDPT

Contact information

Practice address
21701 76TH AVE W, STE. 301, EDMONDS, WA 98026-6200
(425) 472-2681
Mailing address
8810 202ND PL SW, EDMONDS, WA 98026-6636
(425) 320-9974

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60910944
WA
101YM0800X
Mental Health Counselor
LH00008392
WA
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023515400
WA
Enumeration date
07/19/2017
Last updated
03/21/2025
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