Provider Demographics
NPI:1215231386
Name:HARMONY GROVE COUNSELING, INC.
Entity Type:Organization
Organization Name:HARMONY GROVE COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, CLINICAL SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:R
Authorized Official - Last Name:STARTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:BA, CDP
Authorized Official - Phone:509-926-3361
Mailing Address - Street 1:9203 E TRENT AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4216
Mailing Address - Country:US
Mailing Address - Phone:509-926-3361
Mailing Address - Fax:509-927-8420
Practice Address - Street 1:9203 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4216
Practice Address - Country:US
Practice Address - Phone:509-926-3361
Practice Address - Fax:509-927-8420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 00004556101YA0400X
WA32143300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACP 00004556OtherWA STATE CHEMICAL DEPENDENCY PROFESSIONAL