Provider Demographics
NPI:1114246592
Name:PIONEER COUNSELING SERVICES OF SPOKANE
Entity Type:Organization
Organization Name:PIONEER COUNSELING SERVICES OF SPOKANE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP BEHAVIORAL HEALTH GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CDP, LICSW, LMHC
Authorized Official - Phone:206-768-1990
Mailing Address - Street 1:722 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2108
Mailing Address - Country:US
Mailing Address - Phone:509-325-3730
Mailing Address - Fax:509-325-3759
Practice Address - Street 1:722 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2108
Practice Address - Country:US
Practice Address - Phone:509-325-3730
Practice Address - Fax:509-325-3759
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIONEER HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA578077922101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty