MEDICARE: MS. LINDSEY L WILSON LMHC, NCC

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	LH 60238369	WA

General Provider Information

NPI Number	:	1225333610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDSEY L WILSON LMHC, NCC

Provider Business Mailing Address
First Line	:	9515 HOLLY DR
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98204-2609
Country	:	US
Telephone Number	:	651-206-2659
Fax Number	:

Provider Business Practice Location Address
First Line	:	19707 64TH AVE W STE 207
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-5958
Country	:	US
Telephone Number	:	651-206-2659
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2011
Last Update Date	:	03/04/2013

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