Organization
ENLIVENING MENTAL HEALTH
Active
Organization
ENLIVENING MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACI TOLLIVER LMFT, LMHC (EXECUTIVE DIRECTOR; THERAPIST)
(253) 249-5991
Entity
Organization
Contact information
Practice address
106 PLAZA DR SE BLDG B3, YELM, WA 98597-8841
(253) 249-5991
Mailing address
106 PLAZA DR SE BLDG B3, YELM, WA 98597-8841
(253) 249-5991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/03/2021
Last updated
04/03/2021
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