Individual provider Active NPI

Nicholas Arrington Mims, MA, LPC, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1114691730
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61263883 Issued in WA
Practice address
4018 California Ave SW Apt 5
Seattle, WA 98116-3782
Phone
(206) 569-4509
NPI assigned
Aug 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGPC00649 DC
Mental Health Counselor 101YM0800X LH61263883 WA Primary
Mental Health Counselor 101YM0800X PRC200001257 DC

Addresses

Primary practice location

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

Mailing address

100 N Howard St Ste 4424
Spokane, WA 99201-0508
Phone (206) 569-4509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Aug 26, 2024 through Aug 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LGPC00649DCMDMental Health Counselor
PRC200001257DCMDMental Health Counselor
LH61263883WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Self-Inclusive Collective, PLLC Mental Health CurrentSince Apr 9, 2023 Accepting new patients

Locations

100 N Howard St
Spokane, WA 99201
Phone (206) 201-1163

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1114691730",
    "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",
            "telephone_number": "206-569-4509"
        },
        {
            "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": {
        "last_name": "MIMS",
        "first_name": "NICHOLAS",
        "middle_name": "ARRINGTON",
        "credential": "MA, LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-06",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "LGPC00649",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61263883",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC200001257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.