Provider Demographics
NPI:1174226385
Name:CAROLIN, AMY CELESTE (LMFTA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CELESTE
Last Name:CAROLIN
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 BAY SHORE DR NW STE 310
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8220
Mailing Address - Country:US
Mailing Address - Phone:435-260-9943
Mailing Address - Fax:
Practice Address - Street 1:9307 BAY SHORE DR NW STE 310
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8220
Practice Address - Country:US
Practice Address - Phone:435-260-9943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61412409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist