Laurae A Macclain, RC – Mental Health Counselor

Key facts

NPI: 1356569677
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: RC00044878 (WA)
Practice address: 1 Colville Street
Nespelem, WA 99155-0150
Phone: (509) 634-2727
Fax: (509) 634-2781
NPI assigned: Apr 23, 2007
Sex: Female
Sole proprietor: No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
RC00044878	WA	MD	Mental Health Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	RC00044878	WA	Yes

Addresses

Primary practice location

1 Colville Street
Nespelem, WA 99155-0150

Mailing address

1 Colville Street
Nespelem, WA 99155-0150
Phone (509) 634-2727

Other identifiers

Identifier	Type	State	Issuer
1980812	Medicaid	WA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356569677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLVILLE STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550150",
            "telephone_number": "509-634-2727",
            "fax_number": "509-634-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLVILLE STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550150",
            "telephone_number": "509-634-2727",
            "fax_number": "509-634-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCLAIN",
        "first_name": "LAURAE",
        "middle_name": "A",
        "credential": "RC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00044878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980812",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nespelem, WA

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

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.