Provider Demographics
NPI:1538688668
Name:COOMBS, CARRIE ROXANN (LMHC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ROXANN
Last Name:COOMBS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:ROXANN
Other - Last Name:COOMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GILLAM, WOLFE
Mailing Address - Street 1:11914 NE 102ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-2031
Mailing Address - Country:US
Mailing Address - Phone:360-773-7200
Mailing Address - Fax:360-737-6663
Practice Address - Street 1:101 E 8TH ST STE 110
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3294
Practice Address - Country:US
Practice Address - Phone:360-836-1536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-09
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7734101YM0800X
FLTPMC3904.101YM0800X
ID9743101YM0800X
OR9743101YM0800X
WALH60647371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health