Active NPI
Laura Nicole Wood, MA, LMHC, CDP
- Mental Health Counselor
- Vancouver, WA
National Provider Identifier
1023493004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60828865
- Practice address
- 1104 Main St Ste M100
Vancouver, WA 98660 - Phone
- (360) 521-0484
- NPI assigned
- Jul 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP60678437 | WA | |
| Mental Health Counselor | 101YM0800X | LH60828865 | WA | Primary |
Addresses
Primary practice location
1104 Main St Ste M100
Vancouver, WA 98660
Mailing address
PO Box 1208
Vancouver, WA 98666-1208
Phone (360) 521-0484
Other practice location 1
1601 E. 4th Plain Blvd
Bldg. 17, Ste B222
Vancouver, WA 98661
Phone (360) 397-8484 ext. 7880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2066406 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP60678437 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| LH60828865 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1023493004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1208",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986661208",
"telephone_number": "360-521-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 MAIN ST STE M100",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98660",
"telephone_number": "360-521-0484"
}
],
"practiceLocations": [
{
"address_1": "1601 E. 4th Plain Blvd",
"address_2": "Bldg. 17, Ste B222",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "98661",
"country_code": "US",
"telephone_number": "360-397-8484 x7880",
"fax_number": "360-397-8494",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOD",
"first_name": "LAURA",
"middle_name": "NICOLE",
"credential": "MA, LMHC, CDP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-20",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP60678437",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60828865",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2066406",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.