Lorena Mize, MS, SUDP, LMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61443400 Issued in WA

Practice address

4840 Journey St SE
Olympia, WA 98513-6779

Phone

(360) 413-2727

Fax

(360) 455-4620

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Nisqually Tribe

  • Clinic/Center
  • Olympia, WA
  • NPI 1467644914
  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1255718474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 TACOMA AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025416",
            "telephone_number": "253-572-4750",
            "fax_number": "253-272-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 JOURNEY ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985136779",
            "telephone_number": "360-413-2727",
            "fax_number": "360-455-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "LORENA",
        "credential": "MS, SUDP, LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60341708",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61443400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Mitchell, MD
• Hailey Mariah Mixson
• Naomi Miya-Kaposztas, LMP
• Sachiko Miyagi-Hack, INTERPRETER
• Arthur Clarence Mize, L.M.H.C.
• Steven Decierdo Mock, PA-C
• Raymond A. Moeller, M.D.
• Sayyed Arash Jalali Moghaddam, M.D.
• Lul Mohamud
• Maya Mohan

• Mental Health Counselor in Olympia, WA
• Providers in Olympia, 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 26, 2023; 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.