MEDICARE: SERENA LAN ROBLES LMHC, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	14424	CA
2	101YM0800X	Mental Health Counselor	MC60691334	WA
3	101YM0800X	Mental Health Counselor	14424	CA
4	101YM0800X	Mental Health Counselor	LH61125304	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1407331028	OTHER	WA	EXISTING NPI

General Provider Information

NPI Number	:	1407331028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA LAN ROBLES LMHC, LPCC

Provider Business Mailing Address
First Line	:	4030 LAKE WASHINGTON BLVD NE STE 303
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98033-7870
Country	:	US
Telephone Number	:	425-276-2486
Fax Number	:

Provider Business Practice Location Address
First Line	:	4030 LAKE WASHINGTON BLVD NE STE 303
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98033-7870
Country	:	US
Telephone Number	:	425-276-2486
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	02/26/2026

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