MEDICARE: JAMES J INNOCENT MA, LMHC

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	101YM0800X	Mental Health Counselor	MHC.LH.70052693	WA

General Provider Information

NPI Number	:	1578456802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES J INNOCENT MA, LMHC

Provider Business Mailing Address
First Line	:	100 N HOWARD ST # 6581
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 QUEEN ANNE AVE N STE 303
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2876
Country	:	US
Telephone Number	:	781-534-3016
Fax Number	:

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

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	03/16/2026

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