ANGELA WYNONNA SUSILO LMHCA NPI 1831862598

NPI Information

  • NPI: 1831862598
  • Provider Name: ANGELA WYNONNA SUSILO, LMHCA
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 3210 SHOREWOOD DR APT 145
    MERCER ISLAND, WA
    ZIP 98040
  • Phone: (331) 444-9206

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NPI Details

Angela Wynonna Susilo, LMHCA is a mental health counselor in Mercer Island, WA. Angela Wynonna Susilo, LMHCA NPI is 1831862598. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3210 SHOREWOOD DR APT 145
MERCER ISLAND, WA
ZIP 98040-224
Phone: (331) 444-9206

The enumeration date for this NPI number is 7/28/2021 and was last updated on 8/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthMC61094941WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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