Provider Demographics
NPI:1225438997
Name:TSYMBALAU, MAKSIM (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:MAKSIM
Middle Name:
Last Name:TSYMBALAU
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:MAX
Other - Middle Name:
Other - Last Name:TSYMBALAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:2317 N 134TH ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7800
Mailing Address - Country:US
Mailing Address - Phone:206-602-0752
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N
Practice Address - Street 2:SUITE 307
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8626
Practice Address - Country:US
Practice Address - Phone:206-602-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60711517101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health