Provider Demographics
NPI:1073076469
Name:SAGEBRUSH COUNSELING PLLC
Entity Type:Organization
Organization Name:SAGEBRUSH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-770-2955
Mailing Address - Street 1:1702 W MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1312
Mailing Address - Country:US
Mailing Address - Phone:509-242-7200
Mailing Address - Fax:509-593-4676
Practice Address - Street 1:316 W BOONE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2354
Practice Address - Country:US
Practice Address - Phone:509-242-7200
Practice Address - Fax:509-593-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW60876605OtherWA STATE DEPARTMENT OF LICENSING