MEDICARE: MICHELLE CHRISTINE LAFFERRIERE LMHC, CN, SUDP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP60308261	WA
2	133N00000X	Nutritionist	NU60927849	WA
3	101YM0800X	Mental Health Counselor	LH61182147	WA

General Provider Information

NPI Number	:	1992182950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CHRISTINE LAFFERRIERE LMHC, CN, SUDP

Provider Business Mailing Address
First Line	:	4043 S 213TH CT
Second Line	:
City	:	SEATAC
State	:	WA
Zip	:	98198-4248
Country	:	US
Telephone Number	:	425-365-1573
Fax Number	:	425-670-2807

Provider Business Practice Location Address
First Line	:	4043 S 213TH CT
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98198-4248
Country	:	US
Telephone Number	:	425-365-1573
Fax Number	:

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

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	07/08/2024

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