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General NPI Number Information
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NPI Number | 1275212706
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Entity Type | Organization
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Legal Business Name | BLAINE BART THERAPY
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 1423 W GARLAND AVE
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City | SPOKANE
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State | WA
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Zip | 99205-2616
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Country | US
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Telephone | 509-903-6051
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 W SAINT THOMAS MORE WAY
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City | SPOKANE
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State | WA
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Zip | 99208-8252
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Country | US
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Telephone | 509-847-3302
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. BLAINE PATRICK BART
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Credential | LMHC
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Telephone | 509-903-6051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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