Samantha Renee Lynes, NCC, LCMHC, MHC, LPC
Individual provider Active NPI Mental Health Counselor · Tacoma, WA
NPI 1760027445 · NPPES record last updated Apr 20, 2024
Key facts
- NPI
- 1760027445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LH61261913 (WA)
- Practice address
- 11510 19TH Avenue CT S
Tacoma, WA 98444-1434 - Phone
- (253) 508-7857
- NPI assigned
- Nov 17, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
11508 19TH Ave CT S
Tacoma, WA 98444-1434
11510 19TH Ave CT S
Tacoma, WA 98444-1434
PO Box
5299 Ms 820 5 Pco
Tacoma, WA 98415-0299
PO Box
Suite 5299
Tacoma, WA 98415
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250320003027 | WA | Practitioner - Mental Health Counselor | 0446772289 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8126 | OR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current |
Accepting new patients | |
| Multicare Health System | Current |
Accepting new patients | |
| Valera Medical, P.C. | Mental Health | Current |
Accepting new patients |
| Multicare Health System | Current | Accepting new patients | |
| Co-Occurring Therapy, LLC | Mental Health | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C8126 | OR | |
| Mental Health Counselor | 101YM0800X | 15260 | NC | |
| Mental Health Counselor | 101YM0800X | LH61261913 | WA | Yes |
Addresses
Primary practice location
11510 19TH Avenue CT S
Tacoma, WA 98444-1434
Mailing address
1575 Lake Tapps Dr SE Apt 104
Auburn, WA 98092-8774
Phone (253) 508-7857
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1234738 | Other | NBCC | |
| LCMHC15260 | Other | NC | NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS |
| C8126 | Other | OR | OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS AND THERAPISTS |
| LH61261913 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
Other providers in Tacoma, WA
- Diane Lynch
- Kalene Marie Lynch
- Molly Lynch
- Nancy Lee Lynch
- Susan Rachel Lynch
- Joseph Paul Lynn
- Lynne P Clark MD PS
- Andrea Dawn Lyon-Loftus
- Isaak Lyons
- Julie Lyons
All providers in Tacoma, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.