NPIMap

Organization Active NPI

Twin Lakes Counseling, PLLC

Doing business as Twin Lakes Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Federal Way, WA
National Provider Identifier
1053828814
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TWIN LAKES COUNSELING, PLLC
Doing business as
Twin Lakes Counseling
Practice address
3430 SW 320TH St
Federal Way, WA 98023-2292
Phone
(253) 289-6099
Fax
(253) 330-8305
NPI assigned
Jan 2, 2018
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Beth Wallace, PHD, LMFTNPI 1659515013
Title
Owner
Phone
(206) 321-8555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X WA
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X WA
Psychiatric/Mental Health Registered Nurse 163WP0808X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

3430 SW 320TH St
Federal Way, WA 98023-2292

Mailing address

3430 SW 320TH St Ste D2
Federal Way, WA 98023-2292
Phone (253) 289-6099

Other practice location 1

109 N Beach Rd Ste D
Eastsound, WA 98245-8205
Phone (253) 289-6099

Other identifiers 1

IdentifierTypeStateIssuer
2096754MedicaidWA

Other names 1

  • Twin Lakes Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240301002520 WA Part B Supplier - Clinic/Group Practice 3375988298 Receives reassigned benefits from 16 practitioners
Practice locations: Federal Way, WA

National Provider Directory

National Provider Directory

Locations

3430 SW 320th St
Federal Way, WA 98023
Phone (253) 289-6099

3430 SW 320th St
Ste D2
Federal Way, WA 98023
Phone (253) 289-6099

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 73

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1053828814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 SW 320TH ST STE D2",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232292",
            "telephone_number": "253-289-6099",
            "fax_number": "253-231-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 SW 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232292",
            "telephone_number": "253-289-6099",
            "fax_number": "253-330-8305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N Beach Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Eastsound",
            "state": "WA",
            "postal_code": "982458205",
            "country_code": "US",
            "telephone_number": "253-289-6099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TWIN LAKES COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-321-8555",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096754",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Lakes Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.