MEDICARE: REBECCA MCMANUS LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH61007228	WA

General Provider Information

NPI Number	:	1699310953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA MCMANUS LMHC

Provider Business Mailing Address
First Line	:	2005 W TARYN CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W FRANCIS AVE STE 204
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-6858
Country	:	US
Telephone Number	:	509-990-0196
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2019
Last Update Date	:	08/03/2023

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