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MRS. NICOLE RAE MIZUMORI LMFT
NPI 1609264118
Marriage & Family Therapist in Snohomish, WA

Active since January 06, 2015Opted out of Medicare · through Nov 10, 2026
6203 61ST AVE SE, SNOHOMISH, WA 98290(949) 751-7312 Get Directions Write a Review

NPPES record last updated: February 19, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Nicole Rae Mizumori Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. NICOLE RAE MIZUMORI LMFT (NPI 1609264118) is an individual marriage & family therapist in Snohomish, Washington, licensed in Washington (LF60659512) and active in the NPI registry since January 2015. She has opted out of Medicare through November 10, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609264118
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMRS. NICOLE RAE MIZUMORICredential: LMFT
Location Address6203 61ST AVE SESnohomish, WA 98290-5174
Mailing Address6203 61st Ave SeSnohomish, WA 98290-5174 · (949) 751-7312
Phone(949) 751-7312
Sole ProprietorYes
Enumeration DateJanuary 6, 2015
Last NPPES UpdateFebruary 19, 2026
NPPES CertifiedFebruary 19, 2026
✔ NPI 1609264118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in WA · LF60659512
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
6203 61ST AVE SE, Snohomish, WA 98290
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Other Names 1

Other Name (5)Miss Nikki Rae Mizumori

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Nicole Rae Mizumori Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 10, 2024 through November 10, 2026.

Opt-Out Effective DateNovember 10, 2024
Opt-Out In Effect ThroughNovember 10, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Mizumori's NPI number?

The NPI number for Nicole Mizumori is 1609264118. It was assigned to this individual provider in the NPPES registry on January 6, 2015. The provider is also known as Miss Nikki Rae Mizumori.

Where is Nicole Mizumori located?

Nicole Mizumori practices at 6203 61st Ave SE, Snohomish, WA 98290. The listed phone number is (949) 751-7312.

What is Nicole Mizumori's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Nicole Mizumori enrolled in Medicare?

No. Nicole Mizumori has opted out of Medicare through November 10, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Nicole Mizumori was last updated on February 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.