Provider Demographics
NPI:1396283602
Name:KELLER BRICKEY, KAMALA (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KAMALA
Middle Name:
Last Name:KELLER BRICKEY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:NINE MILE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99026-0043
Mailing Address - Country:US
Mailing Address - Phone:509-994-1932
Mailing Address - Fax:
Practice Address - Street 1:715 S COWLEY ST STE 228
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1383
Practice Address - Country:US
Practice Address - Phone:509-473-6706
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00009434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker