1457807331 NPI number — GINGER MICHEL LMHC

Table of content: GINGER MICHEL LMHC (NPI 1457807331)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457807331 NPI number — GINGER MICHEL LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MICHEL
Provider First Name:
GINGER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1457807331
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 2ND AVE N UNIT 1712
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMONDS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98020-2121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-954-7264
Provider Business Mailing Address Fax Number:
206-565-0269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19125 NORTH CREEK PARKWAY
Provider Second Line Business Practice Location Address:
123B
Provider Business Practice Location Address City Name:
BOTHELL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-954-7264
Provider Business Practice Location Address Fax Number:
206-565-0269
Provider Enumeration Date:
08/30/2016

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:  LH60896220 , 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)

  • Identifier: 1255092920 . This is a "TYPE 2 NPI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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