Michelle Nicole Provost, M.S., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60161771 Issued in WA

Practice address

5501 NE 109TH CT
Suite a-1
Vancouver, WA 98662-6177

Phone

(360) 558-5711

Fax

(360) 695-0628

NPI assigned

Jul 1, 2010

Last updated

Apr 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sea - Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Vancouver, WA
  • NPI 1134682115
  NPD (past)
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Vancouver, WA
  • NPI 1437713864
  NPD (past)

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1972815215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 NE 109TH CT",
            "address_2": "SUITE A-1",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626177",
            "telephone_number": "360-558-5711",
            "fax_number": "360-695-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 NE 109TH CT",
            "address_2": "SUITE A-1",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626177",
            "telephone_number": "360-558-5711",
            "fax_number": "360-695-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "credential": "M.S., LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60161771",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "CA",
            "license": "060222650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Health & Services Oregon (Providence Medical Group)
• Providence Health & Services Oregon (Providence Medical Group)
• Providence Health & Services-Oregon (Providence Radiology-Mill Plain)
• Providence Health and Services Oregon (Providence Medical Group)
• Joseph Province, PA
• Pierre E Provost V, M. D.
• Brandy Pruett, BEHAVIOR TECHNICIAN
• David Franklin Pruette, MD
• Kaleen J Pruitt, LMT
• Rebecca Pruitt

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, 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 27, 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.