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General NPI Number Information
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NPI Number | 1427356419
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Entity Type | Organization
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Legal Business Name | INTERVENTION SPECIALISTS, LLC
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 9415 E TRENT AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-4218
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Country | US
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Telephone | 509-838-2111
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Fax | 509-838-2111
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Provider Business Mailing Address
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Address Line | PO BOX 8393
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City | SPOKANE
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State | WA
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Zip | 99203-0393
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Country | US
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Telephone | 509-838-2111
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Fax | 509-838-2111
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | DR. E JOSEPH TERHAAR
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Credential | PH.D.
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Telephone | 509-838-2111
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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 | 20000262
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 020705-LF00001053
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 020703-LH00005453
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License Number State | WA
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