Provider Demographics
NPI:1447495825
Name:WILKS REYNOLDS, JANET H (LMHC IN WA)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:H
Last Name:WILKS REYNOLDS
Suffix:
Gender:F
Credentials:LMHC IN WA
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:H WILKS
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC IN OR
Mailing Address - Street 1:3403 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-5406
Mailing Address - Country:US
Mailing Address - Phone:360-393-7931
Mailing Address - Fax:503-575-2761
Practice Address - Street 1:3403 BROWN RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-5406
Practice Address - Country:US
Practice Address - Phone:360-393-7931
Practice Address - Fax:503-575-2761
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2240101YP2500X
WALH00008011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional