MEDICARE: MS. MARIANNE G GOBLE MA, LMHC, LPC

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	LH60491622	WA
2	101YP2500X	Professional Counselor	C10836	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LH60491622	OTHER	WA	MHC LICENSURE NUMBER

General Provider Information

NPI Number	:	1821365438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIANNE G GOBLE MA, LMHC, LPC

Provider Business Mailing Address
First Line	:	2037 JENSEN ST
Second Line	:
City	:	ENUMCLAW
State	:	WA
Zip	:	98022-3611
Country	:	US
Telephone Number	:	425-241-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 MAIN ST
Second Line	:
City	:	BUCKLEY
State	:	WA
Zip	:	98321-8526
Country	:	US
Telephone Number	:	425-241-4164
Fax Number	:

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

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	11/14/2025

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