MEDICARE: ERIN D'ARCY EARLE MA LMHCA

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	MC60887600	WA

General Provider Information

NPI Number	:	1699240424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN D'ARCY EARLE MA LMHCA

Provider Business Mailing Address
First Line	:	421 NICHOLSON PL NW
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2725
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	271 WYATT WAY NE STE 200
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2873
Country	:	US
Telephone Number	:	206-380-6366
Fax Number	:

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

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	10/08/2018

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