Provider Demographics
NPI:1760642219
Name:KITAGAWA, NOZOMI (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:NOZOMI
Middle Name:
Last Name:KITAGAWA
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600B SW DASH POINT RD # 1121
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-4530
Mailing Address - Country:US
Mailing Address - Phone:425-518-5741
Mailing Address - Fax:
Practice Address - Street 1:14595 BEL RED RD STE 201
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3928
Practice Address - Country:US
Practice Address - Phone:425-326-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2023-06-20
Deactivation Date:2010-05-26
Deactivation Code:
Reactivation Date:2015-04-22
Provider Licenses
StateLicense IDTaxonomies
WALH00010979101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor