Provider Demographics
NPI:1720458656
Name:ALLRED, BRIAN M (LMHC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:ALLRED
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11518 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-3830
Mailing Address - Country:US
Mailing Address - Phone:360-904-5580
Mailing Address - Fax:
Practice Address - Street 1:654 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3836
Practice Address - Country:US
Practice Address - Phone:360-904-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60300360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health