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General NPI Number Information
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NPI Number | 1215231386
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Entity Type | Organization
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Legal Business Name | HARMONY GROVE COUNSELING, INC.
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 9203 E TRENT AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-4216
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Country | US
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Telephone | 509-926-3361
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Fax | 509-927-8420
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Provider Business Mailing Address
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Address Line | 9203 E TRENT AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-4216
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Country | US
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Telephone | 509-926-3361
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Fax | 509-927-8420
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Authorized Official
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Title or Position | ADMINISTRATOR, CLINICAL SUPERVISOR
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Name | MR. DARREL R STARTIN JR.
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Credential | BA, CDP
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Telephone | 509-926-3361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP 00004556
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 32143300
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License Number State | WA
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