Healthcare Provider Details

I. General information

NPI: 1407171119
Provider Name (Legal Business Name): MICHAEL SEAN LAFFERTY M.S. , LMHC, CMHS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 SE TECH CENTER PL STE 300
VANCOUVER WA
98683-5509
US

IV. Provider business mailing address

4216 S MYRTLE ST
SPOKANE WA
99223-6123
US

V. Phone/Fax

Practice location:
  • Phone: 360-619-2226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60567467
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: