Provider Demographics
NPI:1124478953
Name:TOM LUMSDEN'S COUNSELING PRACTICE, LLC
Entity type:Organization
Organization Name:TOM LUMSDEN'S COUNSELING PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LUMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CEAP, SAP
Authorized Official - Phone:253-863-0213
Mailing Address - Street 1:19106 79TH ST E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-7102
Mailing Address - Country:US
Mailing Address - Phone:253-863-0213
Mailing Address - Fax:
Practice Address - Street 1:19106 79TH ST E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-7102
Practice Address - Country:US
Practice Address - Phone:253-863-0213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6028023320010001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health