Healthcare Provider Details

I. General information

NPI: 1033697982
Provider Name (Legal Business Name): LINDSEY N RUSSETT LMHC, CMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
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

10414 NE 25TH ST
VANCOUVER WA
98664-2918
US

V. Phone/Fax

Practice location:
  • Phone: 360-619-2226
  • Fax:
Mailing address:
  • Phone: 708-651-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH61121811
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: