Provider Demographics
NPI:1073216784
Name:PRINCIPE, TONI (LICSW)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:PRINCIPE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 STATE AVE NE # A
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4764
Mailing Address - Country:US
Mailing Address - Phone:360-259-7179
Mailing Address - Fax:360-878-8953
Practice Address - Street 1:2222 STATE AVE NE # A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4764
Practice Address - Country:US
Practice Address - Phone:360-259-7179
Practice Address - Fax:360-878-8953
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW612439211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical