Provider Demographics
NPI:1184814113
Name:MOUNT, LAWANA S (MFT)
Entity type:Individual
Prefix:MS
First Name:LAWANA
Middle Name:S
Last Name:MOUNT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:LAWANA
Other - Middle Name:S
Other - Last Name:MOUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-0457
Mailing Address - Country:US
Mailing Address - Phone:503-580-8856
Mailing Address - Fax:
Practice Address - Street 1:103 S. 1ST ST. SUITE 205
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-580-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YA0400X, 106H00000X
ORC3837101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist