The Self-Inclusive Collective, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE SELF-INCLUSIVE COLLECTIVE, PLLC

Practice address

4018 California Ave SW Apt 5
Seattle, WA 98116-3782

Phone

(206) 569-4509

NPI assigned

Apr 26, 2022

Organization subpart

No

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

Authorized official

Name

Nicholas Mims, LMHC, LPCNPI 1114691730

Title

Member, Licensed Counselor

Phone

(571) 268-1466

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Arrington Mims, MA, LPC, LMHC

  • Mental Health Counselor
  • Seattle, WA
  • NPI 1114691730
  NPD Authorized official
• Makenzie Mims, MA, LMHC, LPC

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1578157525
  NPD (past)

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1104560028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE 4424",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4018 CALIFORNIA AVE SW APT 5",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163782",
            "telephone_number": "206-569-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SELF-INCLUSIVE COLLECTIVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "MEMBER, LICENSED COUNSELOR",
        "authorized_official_telephone_number": "571-268-1466",
        "authorized_official_credential": "LMHC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@selfinclusivecollective.com",
            "affiliation": "N",
            "endpointDescription": "This is the Self-Inclusive Collective email address.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4018 California Ave SW Apt 5",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981163782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Seattle, WA
• Providers in Seattle, 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 Apr 3, 2023; 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.