MEDICARE: NICHOLAS ARRINGTON MIMS MA, LPC, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LGPC00649	DC
2	101YM0800X	Mental Health Counselor	LH61263883	WA
3	101YM0800X	Mental Health Counselor	PRC200001257	DC

General Provider Information

NPI Number	:	1114691730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS ARRINGTON MIMS MA, LPC, LMHC

Provider Business Mailing Address
First Line	:	100 N HOWARD ST STE 4424
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0508
Country	:	US
Telephone Number	:	206-569-4509
Fax Number	:

Provider Business Practice Location Address
First Line	:	4018 CALIFORNIA AVE SW APT 5
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3782
Country	:	US
Telephone Number	:	206-569-4509
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2021
Last Update Date	:	04/03/2023

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