Basic Information
| Provider Information | |||||||||
| NPI: | 1972507622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAUST | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14847 | ||||||||
| Address2: | |||||||||
| City: | TUMWATER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985114847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607544712 | ||||||||
| FaxNumber: | 3603528868 | ||||||||
| Practice Location | |||||||||
| Address1: | 677 WOODLAND SQUARE LOOP SE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | LACEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985031000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607544712 | ||||||||
| FaxNumber: | 3603528868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH00009712 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.