| Ingenuity - Therapeutic Services Pllc | |
|
522 W Riverside Ave Ste N Spokane WA 99201-0580 | |
| (509) 262-5774 | |
| Not Available |
| Full Name | Ingenuity - Therapeutic Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 522 W Riverside Ave Ste N, Spokane, Washington |
| Authorized Official Name and Position | Dustin Haywood (OWNER) |
| Authorized Official Contact | 5092625774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingenuity - Therapeutic Services Pllc 522 W Riverside Ave Ste N Spokane WA 99201-0580 Ph: (509) 262-5774 | Ingenuity - Therapeutic Services Pllc 522 W Riverside Ave Ste N Spokane WA 99201-0580 Ph: (509) 262-5774 |
| NPI Number | 1619717436 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Medicare PECOS PAC ID | 5395284723 |
|---|---|
| Medicare Enrollment ID | O20240828004961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619717436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dustin Fredrick Haywood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013434240 PECOS PAC ID: 6204375637 Enrollment ID: I20240828004997 |
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