The Infinite Well, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60733448 Issued in WA

Legal business name

THE INFINITE WELL, LLC

Practice address

581 Malibu Dr SE
Lacey, WA 98503-1376

Phone

(360) 522-6156

NPI assigned

Jan 12, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Lenita Johnson

Title

Counselor

Phone

(360) 522-6156

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lenita A Marquez, MA LMHC MHP

  • Counselor
  • Lacey, WA
  • NPI 1851820575
  NPD

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1578071486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 LACEY BLVD SE # 8055",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032459",
            "telephone_number": "360-522-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 MALIBU DR SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031376",
            "telephone_number": "360-522-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INFINITE WELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LENITA",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "360-522-6156",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60733448",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Lacey, WA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.