# FIRESIDE PSYCHOTHERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659141786
- **Authorized official:** BORNELL NICHOLSON PHD (FOUNDER & DIRECTOR)
- **Authorized official phone:** (509) 596-1435

## Contact information

- **Practice address:** 201 WESTMINSTER HALL, SPOKANE, WA 99251
- **Practice address phone:** (509) 596-1435
- **Mailing address:** 1818 W FRANCIS AVE \# 299, SPOKANE, WA 99205-6834
- **Mailing address phone:** (509) 596-1435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024