Provider Demographics
NPI:1841502960
Name:GIRON, NICOLE ANTJE (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANTJE
Last Name:GIRON
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 1:1800 COOPER POINT RD SW BLDG 2
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1178
Mailing Address - Country:US
Mailing Address - Phone:360-529-9376
Mailing Address - Fax:
Practice Address - Street 1:1800 COOPER POINT RD SW BLDG 2
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1178
Practice Address - Country:US
Practice Address - Phone:360-529-9376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011502251S00000X
WALH60753092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health