Northwest Mental Health Net

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC 60164023 Issued in WA

Legal business name

NORTHWEST MENTAL HEALTH NET

Practice address

310 N. Meridian Suite 204
Puyallup, WA 98371

Phone

(253) 332-0508

NPI assigned

Jun 7, 2011

Organization subpart

No

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

Authorized official

Name

Lindsey Wilson Nickell, LMHC

Title

Owner

Phone

(253) 332-0508

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1306130448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N. MERIDIAN SUITE 204",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N. MERIDIAN SUITE 204",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-332-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MENTAL HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "NICKELL",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-332-0508",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC 60164023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.