Healthcare Provider Details

I. General information

NPI: 1124824057
Provider Name (Legal Business Name): CAPRICE L. MIMS MSW, LSWAIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N MULLAN RD STE 210-H
SPOKANE VALLEY WA
99206-4366
US

IV. Provider business mailing address

1420 N MULLAN RD STE 210-H
SPOKANE VALLEY WA
99206-4366
US

V. Phone/Fax

Practice location:
  • Phone: 509-217-1183
  • Fax:
Mailing address:
  • Phone: 509-217-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSWIA.SC.61647910
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWIA.SC.61647910
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: