MEDICARE: HOPE HAVEN COUNSELING, PLLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922878339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE HAVEN COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	1121 N ARGONNE RD STE 103
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-2686
Country	:	US
Telephone Number	:	509-951-3713
Fax Number	:	509-271-0384

Provider Business Practice Location Address
First Line	:	1121 N ARGONNE RD STE 103
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-2686
Country	:	US
Telephone Number	:	509-951-3713
Fax Number	:	509-271-0384

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. HEIDI EHRLICH
Credential	:	MA, LMHC, NCC
Telephone Number	:	509-951-3713

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	12/09/2024

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