Provider Demographics
NPI:1275924003
Name:JODIE FIELD & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JODIE FIELD & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC, CSOTP
Authorized Official - Phone:509-826-5731
Mailing Address - Street 1:101 E. DEWBERRY STREET
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841
Mailing Address - Country:US
Mailing Address - Phone:509-826-5731
Mailing Address - Fax:509-826-1278
Practice Address - Street 1:101 E DEWBERRY AVE
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9543
Practice Address - Country:US
Practice Address - Phone:509-826-5731
Practice Address - Fax:509-826-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60240314251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health