Provider Demographics
NPI:1407074669
Name:HENDRIKA MATHER M.S., INC., P.S.
Entity Type:Organization
Organization Name:HENDRIKA MATHER M.S., INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENDRIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:509-925-7522
Mailing Address - Street 1:421 N PEARL ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3193
Mailing Address - Country:US
Mailing Address - Phone:509-925-7522
Mailing Address - Fax:
Practice Address - Street 1:421 N PEARL ST
Practice Address - Street 2:SUITE 209
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3193
Practice Address - Country:US
Practice Address - Phone:509-925-7522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30002968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty