1306997978 NPI number — LAUREEN KAYE MA, LMHC

Table of content: LAUREEN KAYE MA, LMHC (NPI 1306997978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306997978 NPI number — LAUREEN KAYE MA, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAYE
Provider First Name:
LAUREEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAYE
Provider Other First Name:
LORRY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LMHC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306997978
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 433
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUVALL
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98019-0433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-788-9920
Provider Business Mailing Address Fax Number:
425-788-9920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15321 MAIN ST NE
Provider Second Line Business Practice Location Address:
STE #322
Provider Business Practice Location Address City Name:
DUVALL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98019-8574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-788-9920
Provider Business Practice Location Address Fax Number:
425-788-9920
Provider Enumeration Date:
01/12/2007

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:  LH00004830 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: LH00004830 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: LH00004830 . This is a "LICENSED MENTAL HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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