Provider Demographics
NPI:1396893657
Name:ST JOSEPH FAMILY CENTER
Entity type:Organization
Organization Name:ST JOSEPH FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEERER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-483-6495
Mailing Address - Street 1:1016 N SUPERIOR ST
Mailing Address - Street 2:ST JOSEPH FAMILY CENTER
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2059
Mailing Address - Country:US
Mailing Address - Phone:509-483-6495
Mailing Address - Fax:509-483-1541
Practice Address - Street 1:1016 N SUPERIOR ST
Practice Address - Street 2:ST JOSEPH FAMILY CENTER
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2059
Practice Address - Country:US
Practice Address - Phone:509-483-6495
Practice Address - Fax:509-483-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)