Healthcare Provider Details

I. General information

NPI: 1902344955
Provider Name (Legal Business Name): BREANNA LOUISE CARTER MSW CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9921 N NEVADA ST STE 103
SPOKANE WA
99218-1145
US

IV. Provider business mailing address

9921 N NEVADA ST STE 103
SPOKANE WA
99218-1145
US

V. Phone/Fax

Practice location:
  • Phone: 509-581-2690
  • Fax: 509-593-8113
Mailing address:
  • Phone: 509-581-2690
  • Fax: 509-593-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-43831
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60744195
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLW61335526
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO60850463
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: