Healthcare Provider Details

I. General information

NPI: 1336086255
Provider Name (Legal Business Name): BRYNN CENICOLA COUNSELING PROFESSIONAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4113 BRIDGEPORT WAY W STE C
UNIVERSITY PLACE WA
98466-4325
US

IV. Provider business mailing address

4113 BRIDGEPORT WAY W STE C
UNIVERSITY PLACE WA
98466-4325
US

V. Phone/Fax

Practice location:
  • Phone: 615-318-4986
  • Fax:
Mailing address:
  • Phone: 253-642-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRYNN CENICOLA
Title or Position: PRESIDENT
Credential: MA
Phone: 615-318-4986