=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285943233
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARLA ANN CAIN LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2010
-----------------------------------------------------
Last Update Date | 05/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4423 PT. FOSDICK DR. NW STE. 100-6
-----------------------------------------------------
City | GIG HARBOR
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98335-1797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-851-1801
-----------------------------------------------------
Fax | 253-851-4084
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 2406
-----------------------------------------------------
City | GIG HARBOR
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98335-1797
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-851-1801
-----------------------------------------------------
Fax | 253-851-4084
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LH00006276
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------