Jerrod John Beaulieu
Individual provider Active NPI Mental Health Counselor · Lakewood, WA
NPI 1851630792 · NPPES record last updated Feb 13, 2013
Key facts
- NPI
- 1851630792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 9330 59TH Ave SW
Lakewood, WA 98499-2858 - Phone
- (253) 620-5015
- Fax
- (253) 620-5831
- NPI assigned
- Feb 13, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | WA | Yes |
Addresses
Primary practice location
9330 59TH Ave SW
Lakewood, WA 98499-2858
Mailing address
9330 59TH Ave SW
Lakewood, WA 98499-2858
Phone (253) 620-5015
Other providers in Lakewood, WA
- Kimberly Baxter
- Sean Thomas Baxter
- Anna Beach
- Fran Beard
- George Wesley Beatty
- Lori Ann Beaver
- Cheyenne Beckelman
- Donica Julieann Beckman
- Matthew Allen Beckner
- Renee Nicole Becton
All providers in Lakewood, 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 Feb 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.