Individual provider Active NPI

Mia Fine, MS LMFTA

  • Marriage & Family Therapist
  • Seattle, WA
National Provider Identifier
1649647306
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MG60580255 Issued in WA
Practice address
1914 N 34TH St
Suite 401
Seattle, WA 98103-9058
Phone
(561) 203-9087
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG60580255 WA Primary

Addresses

Primary practice location

1914 N 34TH St
Suite 401
Seattle, WA 98103-9058

Mailing address

1914 N 34TH St
Suite 401
Seattle, WA 98103-9058
Phone (561) 203-9087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 15, 2024 through Jan 15, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MG60580255WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PNW Sex Therapy Collective Current Accepting new patients

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1649647306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 N 34TH ST",
            "address_2": "SUITE 401",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981039058",
            "telephone_number": "561-203-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 N 34TH ST",
            "address_2": "SUITE 401",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981039058",
            "telephone_number": "561-203-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "MIA",
        "credential": "MS LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60580255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.