Healthcare Provider Details

I. General information

NPI: 1639909146
Provider Name (Legal Business Name): JASMINE ANN LAYDEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 CARROLL WAY
CHEHALIS WA
98532-9155
US

IV. Provider business mailing address

275 CARROLL WAY
CHEHALIS WA
98532-9155
US

V. Phone/Fax

Practice location:
  • Phone: 360-623-5355
  • Fax:
Mailing address:
  • Phone: 360-623-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61537408
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: