Provider Demographics
NPI:1902505563
Name:LMINAL LLC
Entity Type:Organization
Organization Name:LMINAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DYLAN
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:206-755-1054
Mailing Address - Street 1:7345 164TH AVE NE
Mailing Address - Street 2:STE I145-1410
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7846
Mailing Address - Country:US
Mailing Address - Phone:833-733-0073
Mailing Address - Fax:888-655-4275
Practice Address - Street 1:7345 164TH AVE NE
Practice Address - Street 2:STE I145-1410
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7846
Practice Address - Country:US
Practice Address - Phone:833-733-0073
Practice Address - Fax:888-655-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty