Active NPI
Laura Wall, LMHC
- Mental Health Counselor
- La Conner, WA
National Provider Identifier
1053782086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC.60379285
- Practice address
- 890 Palouse PL
La Conner, WA 98257-9618 - Phone
- (425) 829-0177
- NPI assigned
- Oct 16, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC.60379285 | WA | Primary |
Addresses
Primary practice location
890 Palouse PL
La Conner, WA 98257-9618
Mailing address
890 Palouse PL
La Conner, WA 98257-9618
Phone (425) 829-0177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC.60379285 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1053782086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 PALOUSE PL",
"city": "LA CONNER",
"state": "WA",
"postal_code": "982579618",
"telephone_number": "425-829-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 PALOUSE PL",
"city": "LA CONNER",
"state": "WA",
"postal_code": "982579618",
"telephone_number": "425-829-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "LAURA",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-16",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC.60379285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Conner, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.