Healthcare Provider Details

I. General information

NPI: 1427583772
Provider Name (Legal Business Name): SANJIVANI MARIE CROSS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANJIVANI MARIE SCHRADER

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 N COOK ST
SPOKANE WA
99207-5879
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 509-530-4230
  • Fax: 509-530-4235
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH61181073
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSCHRASM130DA
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: