MEDICARE: NANCY JUSCAMAITA PSYCHOTHERAPY PLLC

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

General Provider Information

NPI Number	:	1770305005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANCY JUSCAMAITA PSYCHOTHERAPY PLLC

Provider Business Mailing Address
First Line	:	215 S ORCAS ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-2442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 S ORCAS ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-2442
Country	:	US
Telephone Number	:	858-224-3972
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NANCY JUSCAMAITA
Credential	:
Telephone Number	:	858-224-3972

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	10/28/2024

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