NPIMap

Organization Active NPI

Family Renewal

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1356782528
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60550441 Issued in WA
Legal business name
FAMILY RENEWAL
Practice address
2015 NE 96TH CT
Vancouver, WA 98664-2980
Phone
(425) 647-5775
Fax
(360) 340-9353
NPI assigned
Jul 16, 2013
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Nicole Laurent, LMHCNPI 1902112634
Title
Owner
Phone
(425) 647-5775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60550441 WA Primary

Addresses

Primary practice location

2015 NE 96TH CT
Vancouver, WA 98664-2980

Mailing address

2015 NE 96TH CT
Vancouver, WA 98664-2980
Phone (425) 647-5775

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1356782528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 NE 96TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642980",
            "telephone_number": "425-647-5775",
            "fax_number": "360-340-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 NE 96TH CT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642980",
            "telephone_number": "425-647-5775",
            "fax_number": "360-340-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY RENEWAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "LAURENT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-647-5775",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60550441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.