MEDICARE: MR. JAMES M FAUST MA 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	LH00009712	WA

General Provider Information

NPI Number	:	1972507622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES M FAUST MA LMHC

Provider Business Mailing Address
First Line	:	12405 TILLEY RD S UNIT 22
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98512-9168
Country	:	US
Telephone Number	:	360-754-4712
Fax Number	:	360-386-1087

Provider Business Practice Location Address
First Line	:	12405 TILLEY RD S UNIT 22
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98512-9168
Country	:	US
Telephone Number	:	360-754-4712
Fax Number	:	360-386-1087

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	12/07/2023

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