Provider Demographics
NPI:1295552347
Name:PETERSON, LAHELA MINERBI (LMHCA)
Entity type:Individual
Prefix:
First Name:LAHELA
Middle Name:MINERBI
Last Name:PETERSON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 HARVEST AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-8620
Mailing Address - Country:US
Mailing Address - Phone:949-981-0484
Mailing Address - Fax:
Practice Address - Street 1:8284 28TH CT NE STE A
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-7161
Practice Address - Country:US
Practice Address - Phone:360-915-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health