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9921 N Nevada St Ste 103 Spokane WA 99218-1145 | |
| (509) 581-2690 | |
| (509) 593-8113 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 9921 N Nevada St Ste 103, Spokane, Washington |
| Authorized Official Name and Position | Kylie Chaffin (OWNER) |
| Authorized Official Contact | 5092429696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9921 N Nevada St Ste 103 Spokane WA 99218-1145 Ph: (509) 581-2690 | 9921 N Nevada St Ste 103 Spokane WA 99218-1145 Ph: (509) 581-2690 |
| NPI Number | 1851947097 |
|---|---|
| Provider Enumeration Date | 08/14/2019 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Medicare PECOS PAC ID | 5294273264 |
|---|---|
| Medicare Enrollment ID | O20240821003465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851947097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kylie Lynn Chaffin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396281903 PECOS PAC ID: 0648718619 Enrollment ID: I20240821003588 |
| Provider Name | Srae Anita Christensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811601875 PECOS PAC ID: 3870026248 Enrollment ID: I20241024001818 |
| Provider Name | Amy Elizabeth Klein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215277595 PECOS PAC ID: 4183157431 Enrollment ID: I20241025001208 |
| Provider Name | Kiah Janessa Siegel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043698657 PECOS PAC ID: 8628501814 Enrollment ID: I20241025003282 |
| Provider Name | Breanna Louise Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902344955 PECOS PAC ID: 8921470774 Enrollment ID: I20241030002830 |
| Provider Name | Emily Mcnichols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023527025 PECOS PAC ID: 1759814676 Enrollment ID: I20241031000726 |
| Provider Name | Morgan Taylor Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699224055 PECOS PAC ID: 1254864069 Enrollment ID: I20241101000188 |
| Provider Name | Kristie Ann Lester |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235378316 PECOS PAC ID: 3274931787 Enrollment ID: I20241112000709 |
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