Individual provider Active NPI

Marisa Larue, MA, LMHC

  • Mental Health Counselor
  • Maple Valley, WA
National Provider Identifier
1730305020
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00006151 Issued in WA
Practice address
22142 SE 237TH St Ste 3
Maple Valley, WA 98038-8550
Phone
(425) 584-7051
Fax
(888) 977-1762
NPI assigned
Apr 17, 2007
Last updated
Dec 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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 LH00006151 WA Primary

Addresses

Primary practice location

22142 SE 237TH St Ste 3
Maple Valley, WA 98038-8550

Mailing address

21619 SE 272ND LN
Maple Valley, WA 98038-3271
Phone (425) 584-7051

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LH00006151WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1730305020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21619 SE 272ND LN",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383271",
            "telephone_number": "425-584-7051",
            "fax_number": "888-977-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22142 SE 237TH ST STE 3",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980388550",
            "telephone_number": "425-584-7051",
            "fax_number": "888-977-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "MARISA",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.