MEDICARE: NUA COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH00010987	WA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDP00004561	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1699927780	OTHER	WA	NPI

General Provider Information

NPI Number	:	1104174465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUA COUNSELING

Provider Business Mailing Address
First Line	:	2505 3RD AVE
Second Line	:	SUITE 325
City	:	SEATTLE
State	:	WA
Zip	:	98121-3418
Country	:	US
Telephone Number	:	206-905-4667
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 3RD AVE
Second Line	:	SUITE 325
City	:	SEATTLE
State	:	WA
Zip	:	98121-3418
Country	:	US
Telephone Number	:	206-905-4667
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ERIN LYNCH
Credential	:	LMHC, CDP, MAC
Telephone Number	:	206-905-4667

Provider Enumeration Date	:	08/16/2012
Last Update Date	:	08/28/2015

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