David Leroy Nicholson-Klingerman Sr., MA LPC, LMHC, CMHS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3354 Issued in OR

Practice address

2204 Pacific Ave N
Long Beach, WA 98631-3300

Phone

(360) 642-3787

Fax

(360) 642-2096

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• David Leroy Klingerman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willapa Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Long Beach, WA
  • NPI 1174570949
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1598823072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787",
            "fax_number": "360-642-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON-KLINGERMAN",
        "first_name": "DAVID",
        "middle_name": "LEROY",
        "name_suffix": "Sr.",
        "credential": "MA LPC, LMHC, CMHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60571247",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "KLINGERMAN",
            "middle_name": "LEROY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jared Mortenson
• Mitchel James Mortenson, AAC
• Amy Murray
• Maddilyn Murray
• Mary Anne Christine Murray, ARNP
• Michael Nolan
• Oceanview Medical Investors, LLC
• One With Life Counseling, PLLC
• Larry David Osterby
• Lori Ann Parker

• Professional Counselor in Long Beach, WA
• Providers in Long Beach, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.