Jaclyn Lane, LMHCA, SUDP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60894412 Issued in WA

Practice address

17311 135TH Ave NE Ste A800
Woodinville, WA 98072-3581

Phone

(425) 409-6414

NPI assigned

Nov 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jaclyn@fullcirclecounselinggroup.com

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1184054520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 FRONT ST N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272914",
            "telephone_number": "425-392-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17311 135TH AVE NE STE A800",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980723581",
            "telephone_number": "425-409-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JACLYN",
        "name_prefix": "Ms.",
        "credential": "LMHCA, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60250615",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60894412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JACLYN@FULLCIRCLECOUNSELINGGROUP.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17311 135th Ave NE Ste A800",
            "city": "Woodinville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980723581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven Labrecque, ND, MPH
• Shaun Adalaide Lachute, ND
• Kirstin M Laib, PHARMD
• Elaine Mattos Lamarche, DC
• Rick Louis Lamarche, DC
• Millicent Lanegraff, ARNP
• Clara S Lee, MSW
• Fred Lee, RPH
• Jennifer Shu-Chun Lee
• Wen Shao Lee, LMFTA

• Mental Health Counselor in Woodinville, WA
• Providers in Woodinville, 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 May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.