Holly Louise Pankratz, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH 60313495 Issued in WA

Practice address

18402 103Rd Ave NE
Bothell, WA 98011-3410

Phone

(206) 715-0915

NPI assigned

Nov 21, 2012

Last updated

Nov 21, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1578807012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21527 30TH AVE SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217870",
            "telephone_number": "206-715-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18402 103RD AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113410",
            "telephone_number": "206-715-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKRATZ",
        "first_name": "HOLLY",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60313495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Pallette, BSN
• Ludette Go Pamesa, LMP
• Lisa Dawn Pamintuan, CPT
• Pan Pacific Health PPLC (Pan Pacific Health)
• Raisa Pankovets, DC
• Benjamin Ross Park, D.O.
• Debbie Park
• Jennifer Ann Park, RN
• Youl N/a Park, AC
• Lili Parman

• Mental Health Counselor in Bothell, WA
• Providers in Bothell, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.