Provider Demographics
NPI:1619772282
Name:TONI PRINCIPE LICSW, PLLC
Entity type:Organization
Organization Name:TONI PRINCIPE LICSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PRINCIPE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-250-1134
Mailing Address - Street 1:1910 EAST 4TH AVE PMB 35
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4632
Mailing Address - Country:US
Mailing Address - Phone:360-207-0660
Mailing Address - Fax:306-515-4753
Practice Address - Street 1:2120 STATE AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-6514
Practice Address - Country:US
Practice Address - Phone:360-297-0660
Practice Address - Fax:306-515-4753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health