Provider Demographics
NPI:1972507622
Name:FAUST, JAMES M (MA LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:FAUST
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12405 TILLEY RD S UNIT 22
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-9168
Mailing Address - Country:US
Mailing Address - Phone:360-754-4712
Mailing Address - Fax:360-386-1087
Practice Address - Street 1:12405 TILLEY RD S UNIT 22
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-9168
Practice Address - Country:US
Practice Address - Phone:360-754-4712
Practice Address - Fax:360-386-1087
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health