Linda J Bannerman, MA

Individual provider Active NPI Mental Health Counselor · Cathlamet, WA

NPI 1104042654 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104042654
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
RC00003433 (WA)
Practice address
42 Elochoman Valley Rd
Cathlamet, WA 98612-9602
Phone
(360) 795-8630
Fax
(360) 795-6224
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
RC00003433WAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X RC00003433 WA Yes

Addresses

Primary practice location

42 Elochoman Valley Rd
Cathlamet, WA 98612-9602

Mailing address

728 N Columbia Heights Rd
Longview, WA 98632-9514
Phone (360) 577-0789

Other identifiers

IdentifierTypeStateIssuer
RC00003433OtherWAREGISTERED COUNSELOR

Other providers in Cathlamet, WA

All providers in Cathlamet, WA · Mental Health Counselor in Washington

Sources for this page

Verify at the official NPI Registry.