Provider Demographics
NPI:1427206705
Name:MENTAL HEALTH PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:MENTAL HEALTH PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:MAGNUSON-WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-462-3320
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:HOODSPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98548-0366
Mailing Address - Country:US
Mailing Address - Phone:360-462-3320
Mailing Address - Fax:360-930-6887
Practice Address - Street 1:2136 OLYMPIC HWY N
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-2953
Practice Address - Country:US
Practice Address - Phone:360-462-3320
Practice Address - Fax:360-930-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009082101YM0800X
101YP2500X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty