MEDICARE: JAMES FAUST & ASSOCIATES PLLC

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	LH00009712	WA

General Provider Information

NPI Number	:	1760656185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES FAUST & ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	12405 TILLEY RD S
Second Line	:	UNIT 22
City	:	OLYMPIA
State	:	WA
Zip	:	98512-9168
Country	:	US
Telephone Number	:	360-754-4712
Fax Number	:	360-386-1087

Provider Business Practice Location Address
First Line	:	12405 TILLEY RD S
Second Line	:	UNIT 22
City	:	OLYMPIA
State	:	WA
Zip	:	98512-9168
Country	:	US
Telephone Number	:	360-754-4712
Fax Number	:	360-386-1087

Authorized Official
Title or Position	:	OWNER/PRACTITIONER
Name	:	MR. JAMES M FAUST
Credential	:	LMHC
Telephone Number	:	360-754-4712

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	01/25/2024

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