Individual provider · Type 1 NPI

Jaclyn Lane, LMHCA, SUDP

Mental Health Counselor · Woodinville, WA

NPI number 1184054520 Active

Practice location

17311 135th Ave NE Ste A800
Woodinville, WA 98072-3581

Call (425) 409-6414 Map

Mailing address

414 Front St N
Issaquah, WA 98027-2914

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XCO60250615 (WA)
Mental Health Counselor Primary 101YM0800XMC60894412 (WA)

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About NPI 1184054520

Jaclyn Lane, LMHCA, SUDP's National Provider Identifier is 1184054520, issued on Nov 21, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Woodinville, WA. The record was last updated on May 19, 2021.