MEDICARE: JANA LYN PERCER MS, LCDC, 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	16997	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP00006215	WA
3	101YP2500X	Professional Counselor	92864	TX

General Provider Information

NPI Number	:	1861758757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA LYN PERCER MS, LCDC, LPC

Provider Business Mailing Address
First Line	:	1611 SUMMIT AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101
Country	:	US
Telephone Number	:	206-323-0930
Fax Number	:	206-323-0930

Provider Business Practice Location Address
First Line	:	3000 OAK SPRINGS DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-2537
Country	:	US
Telephone Number	:	125-786-3369
Fax Number	:

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

Provider Enumeration Date	:	04/05/2012
Last Update Date	:	08/15/2025

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