Provider Demographics
NPI:1790278711
Name:BELABRI, JACLIN LEE (LMHC)
Entity Type:Individual
Prefix:
First Name:JACLIN
Middle Name:LEE
Last Name:BELABRI
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 1:720 SE 160TH AVE, STE 103
Mailing Address - Street 2:#255
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8912
Mailing Address - Country:US
Mailing Address - Phone:360-818-1422
Mailing Address - Fax:360-258-1895
Practice Address - Street 1:15907 NE 12TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-4172
Practice Address - Country:US
Practice Address - Phone:360-818-1422
Practice Address - Fax:360-397-0371
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60859158101Y00000X
WALH61127516101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health