| Innovative Counseling Services, Llc | |
|
707 W 7th Ave Ste 320a Spokane WA 99204-2833 | |
| (509) 863-6822 | |
| (509) 228-3116 |
| Full Name | Innovative Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 707 W 7th Ave Ste 320a, Spokane, Washington |
| Authorized Official Name and Position | Shannon Eileen Mitchell (OWNER OF LLC) |
| Authorized Official Contact | 5098636822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Counseling Services, Llc Po Box 30640 Spokane WA 99223-3010 Ph: (509) 863-6822 | Innovative Counseling Services, Llc 707 W 7th Ave Ste 320a Spokane WA 99204-2833 Ph: (509) 863-6822 |
| NPI Number | 1811468770 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 06/13/2019 |
| Medicare PECOS PAC ID | 9032457254 |
|---|---|
| Medicare Enrollment ID | O20190214000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811468770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shannon Eileen Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538675574 PECOS PAC ID: 4587927694 Enrollment ID: I20180424000036 |
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