1265268932 NPI number — CARRIE ANN STANSELL LMHCA

Table of content: CARRIE ANN STANSELL LMHCA (NPI 1265268932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265268932 NPI number — CARRIE ANN STANSELL LMHCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STANSELL
Provider First Name:
CARRIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHCA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATERSON
Provider Other First Name:
CARRIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHCA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1265268932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7020 NE DOLPHIN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAINBRIDGE IS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98110-1050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-581-0439
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
271 WYATT WAY NE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAINBRIDGE ISLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98110-2873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-581-0439
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MC60243918 , 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)