Healthcare Provider Details
I. General information
NPI: 1811610066
Provider Name (Legal Business Name): MHA SPEAKOUT SPEAKUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2022
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3012 N NEVADA ST STE 1
SPOKANE WA
99207-2800
US
IV. Provider business mailing address
3012 N NEVADA ST STE 1
SPOKANE WA
99207-2800
US
V. Phone/Fax
- Phone: 509-385-5286
- Fax:
- Phone: 509-385-5286
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JOLIE
LYNNE
KNIGHT
Title or Position: DIRECTOR/FOUNDER
Credential:
Phone: 509-428-5618