Provider Demographics
NPI:1427356419
Name:INTERVENTION SPECIALISTS, LLC
Entity type:Organization
Organization Name:INTERVENTION SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:E
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TERHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-838-2111
Mailing Address - Street 1:PO BOX 8393
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0393
Mailing Address - Country:US
Mailing Address - Phone:509-838-2111
Mailing Address - Fax:509-838-2111
Practice Address - Street 1:9415 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4218
Practice Address - Country:US
Practice Address - Phone:509-838-2111
Practice Address - Fax:509-838-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA20000262101YA0400X
WA020703-LH00005453101YM0800X
WA020705-LF00001053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty