Provider Demographics
NPI:1962953125
Name:IMAGINE COUNSELING SPOKANE PLLC
Entity type:Organization
Organization Name:IMAGINE COUNSELING SPOKANE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWNITTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-325-1977
Mailing Address - Street 1:PO BOX 14683
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99214-0683
Mailing Address - Country:US
Mailing Address - Phone:509-822-3709
Mailing Address - Fax:509-323-1607
Practice Address - Street 1:502 N MULLAN RD
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3864
Practice Address - Country:US
Practice Address - Phone:509-822-3709
Practice Address - Fax:509-323-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty