Nicole Churchill, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61458455 Issued in WA

Practice address

19120 SE 34TH St Ste 201
Vancouver, WA 98683-1430

Phone

(360) 906-1190

Fax

(360) 906-1193

NPI assigned

Jul 10, 2020

Last updated

Oct 21, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/discoverybh/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731

  Counselor

  Medicare reassignment Care Compare group NPD
• Jefferson Community Counseling Center

  • Community/Behavioral Health Agency
  • Port Townsend, WA
  • NPI 1083701015
  NPD (past)
• Madrona Institute of Washington

  • Addiction (Substance Use Disorder) Counselor
  • Port Townsend, WA
  • NPI 1154410876
  NPD (past)
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Counselor

  NPD (past)

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1083232532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19120 SE 34TH ST STE 201",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831430",
            "telephone_number": "360-906-1190",
            "fax_number": "360-906-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19120 SE 34TH ST STE 201",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831430",
            "telephone_number": "360-906-1190",
            "fax_number": "360-906-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "NICOLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61458455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chung-Ah Jang DDS PLLC (Harmony Family Dentistry)
• Josephine Eun Sun Chung, LCSW
• Matthew Kwang Joon Chung, DDS
• Alysa A Churape
• George Russell Church, D.M.D.
• Emily Elizabeth Cianci
• Erica Cianni
• Jennifer Dawn Cieslewicz
• Jeffrey Cikler, COTA/L
• Dawnrenee Cinocco, M.D.

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.