Healthcare Provider Details

I. General information

NPI: 1437790870
Provider Name (Legal Business Name): LILA CARTHENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 08/13/2023
Certification Date: 08/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 W WELLESLEY AVE STE B
SPOKANE WA
99205-1413
US

IV. Provider business mailing address

1625 N HARMONY LN
SPOKANE VALLEY WA
99016-8786
US

V. Phone/Fax

Practice location:
  • Phone: 509-795-0080
  • Fax:
Mailing address:
  • Phone: 509-995-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61460672
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: