Grassroots Therapy Group, Llc | |
N 1212 Washington Suite 204 Spokane WA 99201 | |
(509) 279-8838 | |
(509) 267-2717 |
Full Name | Grassroots Therapy Group, Llc |
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Speciality | Clinic/Center |
Location | N 1212 Washington, Spokane, Washington |
Authorized Official Name and Position | Lori Eastep (PARTNER/THERAPIST) |
Authorized Official Contact | 5092798838 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grassroots Therapy Group, Llc N 1212 Washington Suite 204 Spokane WA 99201 Ph: (509) 279-8838 | Grassroots Therapy Group, Llc N 1212 Washington Suite 204 Spokane WA 99201 Ph: (509) 279-8838 |
NPI Number | 1215379086 |
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Provider Enumeration Date | 07/22/2013 |
Last Update Date | 11/20/2024 |
Certification Date | 11/20/2024 |
Medicare PECOS PAC ID | 5092247429 |
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Medicare Enrollment ID | O20241010001009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215379086 | NPI | - | NPPES |
2041796 | Medicaid | WA |
Provider Name | Lori Jean Eastep |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1952650111 PECOS PAC ID: 9537691969 Enrollment ID: I20241015002676 |
Provider Name | Sandra Gormon-brown |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154696086 PECOS PAC ID: 1850837956 Enrollment ID: I20241211002456 |
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