Healthcare Provider Details

I. General information

NPI: 1376447987
Provider Name (Legal Business Name): MN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 S 10TH ST
TACOMA WA
98405-2705
US

IV. Provider business mailing address

2417 S 10TH ST
TACOMA WA
98405-2705
US

V. Phone/Fax

Practice location:
  • Phone: 206-354-5881
  • Fax:
Mailing address:
  • Phone: 206-354-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MACKENZIE R NITZ
Title or Position: PRACTICE OWNER
Credential: LMHC, M.ED
Phone: 206-354-5881