Provider Demographics
NPI:1043764368
Name:TEDDI CRIPPS LLC
Entity Type:Organization
Organization Name:TEDDI CRIPPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TEDDI
Authorized Official - Middle Name:JOELLE
Authorized Official - Last Name:CRIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC
Authorized Official - Phone:509-362-5201
Mailing Address - Street 1:4122 E PRATT AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-5364
Mailing Address - Country:US
Mailing Address - Phone:509-362-5201
Mailing Address - Fax:
Practice Address - Street 1:703 W 7TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2806
Practice Address - Country:US
Practice Address - Phone:509-362-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604005472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty