Deotila Lucas Takulyabwani

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61582811 Issued in WA

Practice address

4570 Avery LN SE
Lacey, WA 98503-5608

Phone

(360) 464-7935

NPI assigned

Apr 1, 2025

Sex

Unspecified or another gender identity

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1760286793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26616 WEBSTER RD E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983387318",
            "telephone_number": "360-402-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 AVERY LN SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035608",
            "telephone_number": "360-464-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKULYABWANI",
        "first_name": "DEOTILA",
        "middle_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61582811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan James Sweet, DC
• Brent Swift, L.AC.
• Synergistic Wellness, LLC
• Laura Franciszka Szkudlarek, LMT
• Reza Tahernia, D.M.D.
• Lois N Talotta, LMP
• Jie Tang
• Tapestry Mental Health PLLC
• Leanne D. Tarr, PA-C
• Aida M. Taulung

• Mental Health Counselor in Lacey, WA
• Providers in Lacey, 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 Apr 1, 2025; 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.