MEDICARE: JENNIFER CARLI 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	LH61210858	WA

General Provider Information

NPI Number	:	1932579679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CARLI LMHC

Provider Business Mailing Address
First Line	:	307 N OLYMPIC AVE STE 210
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1322
Country	:	US
Telephone Number	:	425-977-9220
Fax Number	:	425-818-2696

Provider Business Practice Location Address
First Line	:	307 N OLYMPIC AVE STE 210
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1322
Country	:	US
Telephone Number	:	425-977-9220
Fax Number	:	425-818-2696

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

Provider Enumeration Date	:	10/06/2015
Last Update Date	:	01/16/2023

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