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Organization
INTEGRATIVE PSYCHOLOGICAL AND SOCIAL SERVICES
Active
Organization
INTEGRATIVE PSYCHOLOGICAL AND SOCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE C WINTERS LICSW, PSYD (EXECUTIVE DIRECTOR)
(360) 348-0205
Entity
Organization
Contact information
Practice address
5019 GROVE ST, SUITE 102, MARYSVILLE, WA 98270-4487
(360) 348-0205
(360) 691-9887
Mailing address
5019 GROVE ST, SUITE 102, MARYSVILLE, WA 98270
(360) 348-0205
(360) 691-9887
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC60425258
WA
101YM0800X
Mental Health Counselor
Primary
LH60412214
WA
103TC0700X
Clinical Psychologist
PY60195906
WA
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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