Provider Demographics
NPI:1811316870
Name:PREUSS, MINDY (MA, LMFT)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:PREUSS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1133 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5055
Mailing Address - Country:US
Mailing Address - Phone:360-676-2164
Mailing Address - Fax:
Practice Address - Street 1:614 PETERSON RD STE 200
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-2606
Practice Address - Country:US
Practice Address - Phone:360-676-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60843663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist