Provider Demographics
NPI:1962718858
Name:AMY KNIZEK COUNSELING, PLLC
Entity type:Organization
Organization Name:AMY KNIZEK COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIZEK
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC, CRC
Authorized Official - Phone:509-570-4804
Mailing Address - Street 1:PO BOX 10013
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99209-1013
Mailing Address - Country:US
Mailing Address - Phone:509-570-4804
Mailing Address - Fax:509-242-3002
Practice Address - Street 1:1212 N WASHINGTON ST
Practice Address - Street 2:ONE ROCK POINTE, STE 306
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2403
Practice Address - Country:US
Practice Address - Phone:509-570-4804
Practice Address - Fax:509-242-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60160750251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health