1881979946 NPI number — MR. MACDONALD REID STELL LMHC

Table of content: MR. MACDONALD REID STELL LMHC (NPI 1881979946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881979946 NPI number — MR. MACDONALD REID STELL LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STELL
Provider First Name:
MACDONALD
Provider Middle Name:
REID
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STELL
Provider Other First Name:
REID
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1881979946
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14535 BEL-RED RD
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-457-3038
Provider Business Mailing Address Fax Number:
206-858-9206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14535 BEL-RED RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-457-3038
Provider Business Practice Location Address Fax Number:
206-858-9206
Provider Enumeration Date:
10/19/2011

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:  LH 60425029 , 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: 2127456 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2035234 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LH60425029 . This is a "LMHC LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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