Brian Joseph Nuckols

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61679980 Issued in WA

Practice address

6505 216TH St SW Ste 100
Mountlake Terrace, WA 98043-2089

Phone

(425) 678-6463

NPI assigned

Apr 26, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1063268498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST # 6416",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 216TH ST SW STE 100",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432089",
            "telephone_number": "425-678-6463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Penn Ave Apt 903",
            "address_purpose": "LOCATION",
            "city": "Wilkinsburg",
            "state": "PA",
            "postal_code": "152215010",
            "country_code": "US",
            "telephone_number": "470-263-5725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUCKOLS",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-26",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61679980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.