Healthcare Provider Details

I. General information

NPI: 1437388469
Provider Name (Legal Business Name): AMY KNIZEK M.ED, LMHC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2009
Last Update Date: 12/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 N WASHINGTON ST ONE ROCK POINTE, SUITE 306
SPOKANE WA
99201-2403
US

IV. Provider business mailing address

PO BOX 10013
SPOKANE WA
99209-1013
US

V. Phone/Fax

Practice location:
  • Phone: 509-570-4804
  • Fax: 509-796-5254
Mailing address:
  • Phone: 509-570-4804
  • Fax: 509-242-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH60160750
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: