MEDICARE: MS. NICOLE E KINION LMHC

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 60432638	WA

General Provider Information

NPI Number	:	1699957803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE E KINION LMHC

Provider Business Mailing Address
First Line	:	20102 CEDAR VALLEY RD
Second Line	:	SUITE 106
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6333
Country	:	US
Telephone Number	:	206-940-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	20102 CEDAR VALLEY RD
Second Line	:	SUITE 106
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6333
Country	:	US
Telephone Number	:	206-940-0510
Fax Number	:

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

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	01/24/2014

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