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General NPI Number Information
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NPI Number | 1790835189
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Entity Type | Organization
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Legal Business Name | NORTH PINES COUNSELING PC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 1005 PINES RD N STE 250
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City | SPOKANE VLY
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State | WA
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Zip | 99206-4993
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Country | US
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Telephone | 509-927-1194
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Fax | 509-927-8819
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Provider Business Mailing Address
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Address Line | 1005 PINES RD N STE 250
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City | SPOKANE VLY
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State | WA
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Zip | 99206-4993
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Country | US
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Telephone | 509-927-1194
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Fax | 509-927-8819
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ROB NEILS
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Credential | PH.D.
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Telephone | 509-927-1194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW00005843
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 943
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License Number State | WA
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