Provider Demographics
NPI:1104172451
Name:SPLINTER, BRIAN (MA, NCC, LMHC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:SPLINTER
Suffix:
Gender:M
Credentials:MA, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 HEWITT AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3546
Mailing Address - Country:US
Mailing Address - Phone:253-691-8454
Mailing Address - Fax:425-322-3505
Practice Address - Street 1:1721 HEWITT AVE STE 401
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3546
Practice Address - Country:US
Practice Address - Phone:253-691-8454
Practice Address - Fax:425-322-3505
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60422821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health