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General NPI Number Information
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NPI Number | 1578456802
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Entity Type | Individual
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Provider Name | JAMES J INNOCENT MA, LMHCA
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Gender | Male
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 2800 ELLIOTT AVE PH 7
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City | SEATTLE
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State | WA
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Zip | 98121-1191
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Country | US
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Telephone | 781-534-3016
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N HOWARD ST # 6581
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC61434441
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License Number State | WA
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