Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nathan Ezzo

Individual provider Mental Health Counselor · NPI 1952646903

Nathan Ezzo is a Clinical Social Worker in Burien, Washington. Qualified in 2004, 22 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
22
Licensed in
WA
In the registry since
2012
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

839 SW 126th St
Burien, WA 98146-2752
Phone: (215) 692-3049
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60951940 (WA)
Mental Health Counselor Taxonomy 101YM0800X · Licence SW124649

Record details

NPI number1952646903
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 3, 2012
Last updated in NPPESSeptember 8, 2022
Certification dateSeptember 8, 2022
Mailing address839 Sw 126th St, Burien, WA 98146-2752

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Burien