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NPI Code Detail

MEDICARE: MAGEN BROWN LMHC-A

MEDICARE: MAGEN BROWN LMHC-A
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
1101YM0800XMental Health Counselor
2101YM0800XMental Health CounselorMC61019235WA

General Provider Information

NPI Number : 1336545805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGEN BROWN LMHC-A
Provider Business Mailing Address
First Line : 601 E MCLOUGHLIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3358
Country : US
Telephone Number : 360-281-6824
Fax Number : 360-314-2908
Provider Business Practice Location Address
First Line : 601 E MCLOUGHLIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3358
Country : US
Telephone Number : 360-281-6824
Fax Number : 360-314-2908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2014
Last Update Date : 11/10/2021

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