Nicole Rae Mizumori, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60659512 Issued in WA

Practice address

6203 61St Ave SE
Snohomish, WA 98290-5174

Phone

(949) 751-7312

NPI assigned

Jan 6, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Nikki Rae Mizumori Other name

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

Yes, effective Nov 10, 2024 through Nov 10, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1609264118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6203 61ST AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982905174",
            "telephone_number": "949-751-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6203 61ST AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982905174",
            "telephone_number": "949-751-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUMORI",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60659512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "MIZUMORI",
            "middle_name": "RAE",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gretchen Miles, LMP
• Dana Quigley Miller, RN
• Gisella Miller
• Julia Miller
• Susan Elizabeth Mitchell, L.M.P.
• Roxana Mogharrabin Najafabadi
• Renee Victor Monteiro, M.D.
• Agostinho Antonio Montemor III
• Joshua Montoya
• Patricia Lynn Morris, M.ED LMHC CDP

• Marriage & Family Therapist in Snohomish, WA
• Providers in Snohomish, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.