Provider Demographics
NPI:1437641453
Name:RENDON, DESTINY JUNE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DESTINY
Middle Name:JUNE
Last Name:RENDON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 4TH AVE E STE 501
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1190
Mailing Address - Country:US
Mailing Address - Phone:253-985-5241
Mailing Address - Fax:
Practice Address - Street 1:203 4TH AVE E STE 501
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1190
Practice Address - Country:US
Practice Address - Phone:253-985-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61161616101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health