Individual provider Active NPI

Laura R. Caldwell

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1629213525
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00004062 Issued in WA
Practice address
400 E. Evergreen Blvd.
Suite 100
Vancouver, WA 98660
Phone
(360) 694-4739
Fax
(360) 573-9463
NPI assigned
Dec 5, 2008
Last updated
Dec 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00004062 WA Primary

Addresses

Primary practice location

400 E. Evergreen Blvd.
Suite 100
Vancouver, WA 98660

Mailing address

400 E. Evergreen Blvd.
Suite 100
Vancouver, WA 98660
Phone (360) 694-4739

Other names 1

  • Ms. Laura R Jacobson Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH00004062WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1629213525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E. EVERGREEN BLVD.",
            "address_2": "SUITE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98660",
            "telephone_number": "360-694-4739",
            "fax_number": "360-573-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E. EVERGREEN BLVD.",
            "address_2": "SUITE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98660",
            "telephone_number": "360-694-4739",
            "fax_number": "360-573-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "LAURA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00004062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "JACOBSON",
            "middle_name": "R",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 5, 2008; 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.