Healthcare Provider Details

I. General information

NPI: 1033728415
Provider Name (Legal Business Name): BEYOND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S FREYA ST STE GREEN210
SPOKANE WA
99202-4862
US

IV. Provider business mailing address

104 S FREYA ST STE GREEN210
SPOKANE WA
99202-4862
US

V. Phone/Fax

Practice location:
  • Phone: 509-368-9863
  • Fax:
Mailing address:
  • Phone: 509-368-9863
  • Fax: 509-587-1575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA MARIE MELLO
Title or Position: CEO
Credential: LICSW
Phone: 509-869-9457