Provider Demographics
NPI:1265561765
Name:MANTZ-SIMMONS, LINDA ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:MANTZ-SIMMONS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:43716 SE 149TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-9322
Mailing Address - Country:US
Mailing Address - Phone:970-214-0997
Mailing Address - Fax:425-292-3551
Practice Address - Street 1:6505 216TH ST SW STE 100
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2089
Practice Address - Country:US
Practice Address - Phone:425-640-7009
Practice Address - Fax:425-678-6455
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60457989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist