Provider Demographics
NPI:1295264257
Name:KANUNGO, PRIYA ASHLEY (LICSW)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:ASHLEY
Last Name:KANUNGO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:PRIYA
Other - Middle Name:ASHLEY
Other - Last Name:SEKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 15TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5103
Mailing Address - Country:US
Mailing Address - Phone:206-326-3000
Mailing Address - Fax:206-326-2785
Practice Address - Street 1:2103 S ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-3615
Practice Address - Country:US
Practice Address - Phone:206-329-2050
Practice Address - Fax:206-726-8564
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW61129807101YM0800X, 104100000X
WASC60774360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health