Provider Demographics
NPI:1235193079
Name:PRICE, WILBUR LAMAR (LMHC)
Entity Type:Individual
Prefix:MR
First Name:WILBUR
Middle Name:LAMAR
Last Name:PRICE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:MARTIN
Other - Middle Name:LAMAR
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:109 NW 171ST ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3612
Mailing Address - Country:US
Mailing Address - Phone:206-546-8076
Mailing Address - Fax:
Practice Address - Street 1:10522 LAKE CITY WAY NE
Practice Address - Street 2:C-201
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7765
Practice Address - Country:US
Practice Address - Phone:206-524-3888
Practice Address - Fax:206-524-3890
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003405101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health