Healthcare Provider Details

I. General information

NPI: 1477079259
Provider Name (Legal Business Name): JOHN ALFRED LEMBO JR. LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 6TH AVE STE 826
SEATTLE WA
98121-2593
US

IV. Provider business mailing address

2033 6TH AVE STE 826
SEATTLE WA
98121-2593
US

V. Phone/Fax

Practice location:
  • Phone: 206-414-8918
  • Fax:
Mailing address:
  • Phone: 206-414-8918
  • Fax: 206-726-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61218061
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: