Provider Demographics
NPI:1376819441
Name:HAYES-ELLINGWOOD COUNSELING SERVICES
Entity Type:Organization
Organization Name:HAYES-ELLINGWOOD COUNSELING SERVICES
Other - Org Name:THE CENTER FOR CHILDREN AND FAMILIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER, THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RIANN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:ELLINGWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:509-483-1866
Mailing Address - Street 1:4407 N DIVISION ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1613
Mailing Address - Country:US
Mailing Address - Phone:509-483-1866
Mailing Address - Fax:509-483-1876
Practice Address - Street 1:4407 N DIVISION ST STE 304
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1613
Practice Address - Country:US
Practice Address - Phone:509-483-1866
Practice Address - Fax:509-483-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010674101YM0800X
WALW000086131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty