Individual provider Active NPI

Nicollette McClanahan, MA, LMHC, LMFT-A,MHP

  • Mental Health Counselor
  • Chehalis, WA
National Provider Identifier
1295398956
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61371800 Issued in WA
Practice address
151 NE Hampe Way
Chehalis, WA 98532-2403
Phone
(360) 345-6790
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG61299687 WA
Mental Health Counselor 101YM0800X LH61371800 WA Primary

Addresses

Primary practice location

151 NE Hampe Way
Chehalis, WA 98532-2403

Mailing address

2428 W Reynolds Ave
Centralia, WA 98531-4554
Phone (360) 330-9988

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240617003242 WA Practitioner - Mental Health Counselor 3779026836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Community HealthcareGroup PAC ID 5496641177, 14 clinicians

Practice addresses (Care Compare)

2428 W Reynolds Ave
Centralia, WA 98531-4554
Phone (360) 330-9044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MG61299687WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Community Healthcare Mental Health CurrentSince Apr 20, 2024 Accepting new patients
Cascade Community Healthcare CurrentSince Apr 20, 2024 Accepting new patients

Locations

2428 W Reynolds Ave
Centralia, WA 98531

151 NE Hampe Way
Chehalis, WA 98532
Phone (360) 345-6790

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1295398956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 W REYNOLDS AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314554",
            "telephone_number": "360-330-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 NE HAMPE WAY",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322403",
            "telephone_number": "360-345-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLANAHAN",
        "first_name": "NICOLLETTE",
        "name_prefix": "Mrs.",
        "credential": "MA, LMHC, LMFT-A,MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG61299687",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61371800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.