1356728828 NPI number — LAREE RUMBLE LMHC COUNSELING

Table of content: (NPI 1356728828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356728828 NPI number — LAREE RUMBLE LMHC COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAREE RUMBLE LMHC COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAREE RUMBLE LMHC COUNSELING SERVICES LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356728828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 VALLEY MALL PKWY
Provider Second Line Business Mailing Address:
BOX 405
Provider Business Mailing Address City Name:
EAST WENATCHEE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98802-4838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-679-2380
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 S MISSION ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-679-2380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2015

Additional Information

Authorized Official

Authorized Official Last Name:
RUMBLE
Authorized Official First Name:
LAREE
Authorized Official Middle Name:
ANNETTE
Authorized Official Title or Position:
LICENSED MENTAL HEALTH COUNSELOR
Authorized Official Telephone Number:
509-679-2380

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LH60296884 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com