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General NPI Number Information
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NPI Number | 1932077559
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Entity Type | Organization
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Legal Business Name | ROCKDALE MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 522 W RIVERSIDE AVE # 7003
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 509-245-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE # 7003
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 509-245-7575
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL BURRESS
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Credential | APRN
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Telephone | 931-629-4941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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