JOHNATHAN SAMUEL DETWILER LMHC NPI 1558829457

NPI Information

NPI: 1558829457
Provider Name: JOHNATHAN SAMUEL DETWILER, LMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
5501 NE 109TH CT STE A1
VANCOUVER, WA
ZIP 98662
Phone: (360) 566-4432
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Johnathan Samuel Detwiler, LMHC is a mental health counselor in Vancouver, WA. Johnathan Samuel Detwiler, LMHC NPI is 1558829457. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5501 NE 109TH CT STE A1
VANCOUVER, WA
ZIP 98662-173
Phone: (360) 566-4432

The enumeration date for this NPI number is 3/10/2019 and was last updated on 10/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C5666	OREGON	No
2	101YM0800X	Counselor	Mental Health	LH61055500	WASHINGTON	Yes
3	101YM0800X	Counselor	Mental Health	39003508A	INDIANA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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